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Aceituno D, Razzouk D, Jin H, Pennington M, Gadelha A, Bressan R, Noto C, Crossley N, Prina M. Cost-effectiveness of early intervention in psychosis in low- and middle-income countries: economic evaluation from São Paulo, Brazil. Epidemiol Psychiatr Sci 2024; 33:e21. [PMID: 38576239 PMCID: PMC11022262 DOI: 10.1017/s2045796024000222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 01/16/2024] [Accepted: 03/08/2024] [Indexed: 04/06/2024] Open
Abstract
AIMS The effectiveness and cost-effectiveness of early intervention for psychosis (EIP) services are well established in high-income countries but not in low- and middle-income countries (LMICs). Despite the scarcity of local evidence, several EIP services have been implemented in LMICs. Local evaluations are warranted before adopting speciality models of care in LMICs. We aimed to estimate the cost-effectiveness of implementing EIP services in Brazil. METHODS A model-based economic evaluation of EIP services was conducted from the Brazilian healthcare system perspective. A Markov model was developed using a cohort study conducted in São Paulo. Cost data were retrieved from local sources. The outcome of interest was the incremental cost-effectiveness ratio (ICER) measured as the incremental costs over the incremental quality-adjusted life-years (QALYs). Sensitivity analyses were performed to test the robustness of the results. RESULTS The study included 357 participants (38% female), with a mean (SD) age of 26 (7.38) years. According to the model, implementing EIP services in Brazil would result in a mean incremental cost of 4,478 Brazilian reals (R$) and a mean incremental benefit of 0.29 QALYs. The resulting ICER of R$ 15,495 (US dollar [USD] 7,640 adjusted for purchase power parity [PPP]) per QALY can be considered cost-effective at a willingness-to-pay threshold of 1 Gross domestic product (GDP) per capita (R$ 18,254; USD 9,000 PPP adjusted). The model results were robust to sensitivity analyses. CONCLUSIONS This study supports the economic advantages of implementing EIP services in Brazil. Although cultural adaptations are required, these data suggest EIP services might be cost-effective even in less-resourced countries.
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Affiliation(s)
- D. Aceituno
- Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile
- King’s Health Economics, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, David Goldberg Centre, London, UK
- Mental Health Service, Complejo Asistencial Dr. Sotero del Rio, Puente Alto, Chile
| | - D. Razzouk
- Centre of Mental Health Economics, Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - H. Jin
- King’s Health Economics, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, David Goldberg Centre, London, UK
| | - M. Pennington
- King’s Health Economics, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, David Goldberg Centre, London, UK
| | - A. Gadelha
- Schizophrenia Program (PROESQ), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - R. Bressan
- Schizophrenia Program (PROESQ), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - C. Noto
- Schizophrenia Program (PROESQ), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - N. Crossley
- Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - M. Prina
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
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Leusin F, Damiano RF, Mendes LST, Hoffmann MS, Manfro AG, Pan PM, Gadelha A, de Jesus Mari J, Manfro GG, Miguel EC, Rohde LA, Bressan RA, Salum GA. Perinatal and neonatal factors and mental disorders in children and adolescents: looking for the contributions of the early environment to common and dissociable aspects of psychopathology. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02402-0. [PMID: 38519607 DOI: 10.1007/s00787-024-02402-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 02/17/2024] [Indexed: 03/25/2024]
Abstract
High rates of co-occurrence of mental disorders have been hypothesized to represent a result of common susceptibility to overall psychopathology. The purpose of this study is to test the hypothesis that commonalities among psychiatric disorders might be partially driven by sharable perinatal and neonatal environmental factors for mental disorders. Participants were 6-14 years of age children and their parents. Primary caregivers provided data on perinatal and neonatal information assessed retrospectively (n = 2231). Psychiatric disorders diagnoses were assessed using the Development and Well Being Behavior Assessment (DAWBA). We used bifactor models to disentangle common from dissociable aspects of psychopathology. These models allow modeling psychiatric disorders as the result of a common domain of psychopathology (p-factor) and three dissociable domains (fear, distress, and externalizing symptoms). Associations were tested using linear and tobit regression models. The p-factor was associated with male sex, low socioeconomic status, gestational smoking, gestational drinking, low levels of maternal education and presence of mental disorder in the mother. Associations with specific factors also emerged suggesting some risk factors might also have some role for fear, distress and externalizing factors. Our study supports the hypothesis that overall susceptibility to psychopathology might be partially driven by sharable perinatal and neonatal factors.
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Affiliation(s)
- Fabiane Leusin
- Section On Negative Affect and Social Process, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
| | - Rodolfo Furlan Damiano
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil.
- Instituto de Psiquiatria da Faculdade de Medicina da USP, Rua Ovídio Pires de Campos, 785-Cerqueira César, São Paulo, SP, 05403-903, Brazil.
| | - Lorenna Sena Teixeira Mendes
- Section On Negative Affect and Social Process, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
| | - Maurício Scopel Hoffmann
- Department of Neuropsychiatry, Universidade Federal de Santa Maria (UFSM), Camobi, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Mental Health Epidemiology Group (MHEG), Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
- London School of Economics and Political Science, Care Policy and Evaluation Centre, London, UK
| | - Arthur Gus Manfro
- Section On Negative Affect and Social Process, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
| | - Pedro Mario Pan
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
- Departamento de Psiquiatria da Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ary Gadelha
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
- Departamento de Psiquiatria da Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Jair de Jesus Mari
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
- Departamento de Psiquiatria da Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Gisele Gus Manfro
- Section On Negative Affect and Social Process, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
| | - Eurípedes Constantino Miguel
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
- Instituto de Psiquiatria da Faculdade de Medicina da USP, Rua Ovídio Pires de Campos, 785-Cerqueira César, São Paulo, SP, 05403-903, Brazil
| | - Luis Augusto Rohde
- Section On Negative Affect and Social Process, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
| | - Rodrigo Affonseca Bressan
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
- Departamento de Psiquiatria da Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Giovanni Abrahão Salum
- Section On Negative Affect and Social Process, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
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Hoffmann MS, Pine DS, Georgiades K, Szatmari P, Miguel EC, Pan PM, Gadelha A, Rohde LA, Merikangas KR, Milham MP, Satterthwaite TD, Salum GA. Comparing mental health semi-structured diagnostic interviews and symptom checklists to predict poor life outcomes: an 8-year cohort study from childhood to young adulthood in Brazil. Lancet Glob Health 2024; 12:e79-e89. [PMID: 37980914 PMCID: PMC10716620 DOI: 10.1016/s2214-109x(23)00462-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 09/13/2023] [Accepted: 09/28/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Semi-structured diagnostic interviews and symptom checklists present similar internal reliability. We aim to investigate whether they differ in predicting poor life outcomes in the transition from childhood to young adulthood. METHODS For this longitudinal study, we used data from the Brazilian High Risk Cohort Study for Childhood Mental Health Conditions. Eligible participants were aged 6-14 years on the day of study enrolment (January to February, 2010) and were enrolled in public schools by a biological parent in Porto Alegre and São Paulo, Brazil. 2511 young people and their caregivers were assessed at baseline in 2010-11, and 1917 were assessed 8 years later (2018-19; 76·3% retention). Clinical thresholds were derived using semi-structured parent-report interview based on the Diagnostic and Statistical Manual of Mental Disorders, according to the Developmental and Well-being Assessment (DAWBA), and clinical scores as defined by the Child Behavior Checklist (CBCL; T-score ≥70 considered positive caseness). At 8 years, participants were assessed for a composite life-threatening outcome (a composite of death, suicide attempts, severe self-harm, psychiatric inpatient admission, or emergency department visits) and a composite poor life chances outcome (a composite of any criminal conviction, substance misuse, or school dropout). We evaluated the accuracy of DAWBA and CBCL to predict these outcomes. Logistic regression models were adjusted for age, sex, race or ethnicity, study site, and socioeconomic class. FINDINGS DAWBA and CBCL had similar sensitivity, specificity, predictive values, and test accuracy for both composite outcomes and their components. Any mental health problem, as classified by DAWBA and CBCL, was independently associated with the composite life-threatening outcome (DAWBA adjusted odds ratio 1·62, 95% CI 1·20-2·18; CBCL 1·66, 1·19-2·30), but only CBCL independently predicted poor life chances (1·56, 1·19-2·04). Participants classified by both approaches did not have higher odds of the life-threatening outcome when compared with participants classified by DAWBA or CBCL alone, nor for the poor life chances outcome when compared with those classified by CBCL alone. INTERPRETATION Classifying children and adolescents based on a semi-structured diagnostic interview was not statistically different to symptom checklist in terms of test accuracy and predictive validity for relevant life outcomes. Classification based on symptom checklist might be a valid alternative to costly and time-consuming methods to identify young people at risk for poor life outcomes. FUNDING Conselho Nacional de Desenvolvimento Científico e Tecnológico; Fundação de Amparo à Pesquisa do Estado de São Paulo; and Medical Research Council, European Research Council. TRANSLATION For the Portuguese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Mauricio Scopel Hoffmann
- Department of Neuropsychiatry and Mental Health Epidemiology Group (MHEG), Universidade Federal de Santa Maria, Santa Maria, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK.
| | - Daniel S Pine
- Section on Developmental Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, USA
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada; Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, ON, Canada
| | - Euripedes Constantino Miguel
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil; Universidade de São Paulo, São Paulo, Brazil
| | - Pedro Mario Pan
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil; Laboratório Interdisciplinar de Neurociências Clínicas, Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ary Gadelha
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil; Departamento de Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Luis Augusto Rohde
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry and Legal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
| | - Kathleen Ries Merikangas
- Genetic Epidemiology Research Branch, National Institute of Mental Health Intramural Research Program, Bethesda, MD, USA
| | - Michael Peter Milham
- Nathan S Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Child Mind Institute, New York, NY, USA
| | - Theodore Daniel Satterthwaite
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Informatics and Neuroimaging Center, Philadelphia, PA, USA
| | - Giovanni Abrahão Salum
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry and Legal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil; Child Mind Institute, New York, NY, USA
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Malinowski F, Noto C, Cavalcante D, Belangero S, Ziebold C, Bressan R, Gadelha A. Urban distance to mental healthcare units and public transport increases duration of untreated psychosis in first-episode patients. Int J Soc Psychiatry 2023; 69:1938-1948. [PMID: 37332226 DOI: 10.1177/00207640231180825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
BACKGROUND There is a growing interest in environmental and social determinants of mental health. However, how distance to healthcare and public transportation affect illness is neglected in schizophrenia research. Here, we are interested in how the availability of mental healthcare and the ways to reach it may be associated with psychosis. AIMS We aim to investigate the association between distances to healthcare units and subway stations and duration of untreated psychosis (DUP) and greater initial severity in an antipsychotic-naïve first episode of psychosis (FEP) sample. METHOD Using 212 untreated FEP patients' data, we calculated the distances from their residences to the places of interest. Diagnoses comprehended schizophrenia spectrum disorders, depressive and bipolar affective disorders, and substance-induced disorders. Linear regressions were performed with distances as independent variables, DUP and Positive and Negative Syndrome Scale (PANSS) scores as dependent variables. RESULTS Longer distance to emergency mental healthcare was related to longer DUP (95% CI: p = .034, B = 0.152) and higher total PANSS (95% CI: p = .007, B = 0.0189); longer distance to community mental healthcare units was related to longer DUP (95% CI: p = .004, B = 0.0204) and higher total PANSS (95% CI: p = .030, B = 0.152). Moreover, a longer distance to the closest subway station predicted longer DUP (95% CI: p = .019, B = 0.170). CONCLUSION Our results indicate that poor healthcare access is related to longer DUP and higher initial PANSS scores. Future research should investigate how investments in mental health access and actions to improve public transport access could impact DUP and treatment outcomes in psychosis patients.
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Affiliation(s)
- Fernando Malinowski
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Programa de Esquizofrenia (PROESQ), Departamento de Psiquiatria, EPM-UNIFESP, São Paulo, SP, Brazil
| | - Cristiano Noto
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Programa de Esquizofrenia (PROESQ), Departamento de Psiquiatria, EPM-UNIFESP, São Paulo, SP, Brazil
- Grupo de Atenção às Psicoses Iniciais (GAPi), Departamento de Psiquiatria, EPM-UNIFESP, São Paulo, SP, Brazil
| | - Daniel Cavalcante
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Grupo de Atenção às Psicoses Iniciais (GAPi), Departamento de Psiquiatria, EPM-UNIFESP, São Paulo, SP, Brazil
| | - Síntia Belangero
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Department of Morphology and Genetics, EPM-UNIFESP, São Paulo, SP, Brazil
| | - Carolina Ziebold
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Rodrigo Bressan
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Programa de Esquizofrenia (PROESQ), Departamento de Psiquiatria, EPM-UNIFESP, São Paulo, SP, Brazil
| | - Ary Gadelha
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Centro de Pesquisa e Inovação em Prevenção de Transtornos Mentais e Uso de Álcool e Outras Drogas (CEPIPREV), EPM-UNIFESP, São Paulo, SP, Brazil
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Caliman-Fontes AT, Leal GC, Gadelha A, Quarantini LC. Discussing clozapine adverse effects and monitoring strategies: a focus on ethnic diversity. Braz J Psychiatry 2023; 45:461-462. [PMID: 37792800 PMCID: PMC10894632 DOI: 10.47626/1516-4446-2023-3289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 08/16/2023] [Indexed: 10/06/2023]
Affiliation(s)
- Ana Teresa Caliman-Fontes
- Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brazil. Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Gustavo C Leal
- Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brazil. Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Ary Gadelha
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Lucas C Quarantini
- Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brazil. Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil
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Diniz E, Fonseca L, Rocha D, Trevizol A, Cerqueira R, Ortiz B, Brunoni AR, Bressan R, Correll CU, Gadelha A. Treatment resistance in schizophrenia: a meta-analysis of prevalence and correlates. Braz J Psychiatry 2023; 45:448-458. [PMID: 37718484 PMCID: PMC10894625 DOI: 10.47626/1516-4446-2023-3126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/19/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVES To determine the prevalence and correlates of treatment-resistant schizophrenia (TRS) through a systematic review and meta-analysis. METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, an electronic search was performed in PubMed and Embase through May 17, 2022. All study designs that assessed a minimum of 20 schizophrenia-spectrum patients and provided data on TRS prevalence or allowed its calculation were included. Estimates were produced using a random-effects model meta-analysis. RESULTS The TRS prevalence across 50 studies (n = 29,390) was 36.7% (95%CI 33.1-40.5, p < 0.0001). The prevalence ranged from 22% (95%CI 18.4-25.8) in first-episode to 39.5% (95%CI 32.2-47.0) in multiple-episode samples (Q = 18.27, p < 0.0001). Primary treatment resistance, defined as no response from the first episode, was 23.6% (95%CI 20.5-26.8) vs. 9.3% (95%CI 6.8-12.2) for later-onset/secondary (≥ 6 months after initial treatment response). Longer illness duration and recruitment from long-term hospitals or clozapine clinics were associated with higher prevalence estimates. In meta-regression analyses, older age and poor functioning predicted greater TRS. When including only studies with lower bias risk, the TRS prevalence was 28.4%. CONCLUSION Different study designs and recruitment strategies accounted for most of the observed heterogeneity in TRS prevalence rates. The results point to early-onset and later-onset TRS as two separate disease pathways requiring clinical attention.
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Affiliation(s)
- Elton Diniz
- Laboratório Interdisciplinar de Neurociências Clínicas, Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Programa de Esquizofrenia, Departamento de Psiquiatria, UNIFESP, São Paulo, SP, Brazil
| | - Lais Fonseca
- Laboratório Interdisciplinar de Neurociências Clínicas, Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Programa de Esquizofrenia, Departamento de Psiquiatria, UNIFESP, São Paulo, SP, Brazil
| | - Deyvis Rocha
- Laboratório Interdisciplinar de Neurociências Clínicas, Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Programa de Esquizofrenia, Departamento de Psiquiatria, UNIFESP, São Paulo, SP, Brazil
| | - Alisson Trevizol
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Raphael Cerqueira
- Laboratório Interdisciplinar de Neurociências Clínicas, Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Programa de Esquizofrenia, Departamento de Psiquiatria, UNIFESP, São Paulo, SP, Brazil
| | - Bruno Ortiz
- Laboratório Interdisciplinar de Neurociências Clínicas, Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Programa de Esquizofrenia, Departamento de Psiquiatria, UNIFESP, São Paulo, SP, Brazil
| | - André R. Brunoni
- Serviço Interdisciplinar de Neuromodulação, Departamento de Psiquiatria, Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
- Laboratório de Neurociências, Departamento de Psiquiatria, Instituto de Psiquiatria, USP, São Paulo, SP, Brazil
| | - Rodrigo Bressan
- Laboratório Interdisciplinar de Neurociências Clínicas, Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Christoph U. Correll
- Department of Psychiatry, The Zucker Hillside Hospital, New York, NY, USA
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Ary Gadelha
- Laboratório Interdisciplinar de Neurociências Clínicas, Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Programa de Esquizofrenia, Departamento de Psiquiatria, UNIFESP, São Paulo, SP, Brazil
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Mota NB, Ribeiro M, Malcorra BLC, Atídio JP, Haguiara B, Gadelha A. Happy thoughts: What computational assessment of connectedness and emotional words can inform about early stages of psychosis. Schizophr Res 2023; 259:38-47. [PMID: 35811267 DOI: 10.1016/j.schres.2022.06.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/17/2022] [Accepted: 06/22/2022] [Indexed: 11/29/2022]
Abstract
In recent years, different natural language processing tools measured aspects related to narratives' structural, semantic, and emotional content. However, there is a need to better understand the limitations and effectiveness of speech elicitation protocols. The graph-theoretical analysis applied to short narratives reveals lower connectedness associated with negative symptoms even in the early stages of psychosis, but emotional topics seem more informative than others. We investigate the interaction between connectedness and emotional words with negative symptoms and educational level in participants with and without psychosis. For that purpose, we used a speech elicitation protocol based on three positive affective pictures and calculated the proportion of emotional words and connectedness measures in the first-episode psychosis (FEP) group (N: 24) and a control group (N: 33). First, we replicated the association between connectedness and negative symptoms (R2: 0.53, p: 0.0049). Second, the more positive terms, the more connected the narrative was, exclusively under psychosis and in association with education, pointing to an interaction between symptoms and formal education. Negative symptoms were independently associated with connectedness, but not with emotional words, although the associations with education were mutually dependent. Together, education and symptoms explained almost 70 % of connectedness variance (R2: 0.67, p < 0.0001), but not emotional expression. At this initial stage of psychosis, education seems to play an important role, diminishing the impact of negative symptoms on the narrative connectedness. Negative symptoms in FEP impact narrative connectedness in association with emotional expression, revealing aspects of social cognition through a short and innocuous protocol.
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Affiliation(s)
- Natália Bezerra Mota
- Department of Psychiatry and Legal Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil; Research department at Motrix Lab, Motrix, Rio de Janeiro, Brazil.
| | - Marina Ribeiro
- Research department at Motrix Lab, Motrix, Rio de Janeiro, Brazil
| | | | - João Paulo Atídio
- Schizophrenia Program (PROESQ), Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP), Brazil
| | - Bernardo Haguiara
- Schizophrenia Program (PROESQ), Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP), Brazil
| | - Ary Gadelha
- Schizophrenia Program (PROESQ), Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP), Brazil
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8
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Zugman A, Alliende L, Medel V, Bethlehem RA, Seidlitz J, Ringlein G, Arango C, Arnatkevičiūtė A, Asmal L, Bellgrove M, Benegal V, Bernardo M, Billeke P, Bosch-Bayard J, Bressan R, Busatto G, Castro M, Chaim-Avancini T, Compte A, Costanzi M, Czepielewski L, Dazzan P, de la Fuente-Sandoval C, Di Forti M, Díaz-Caneja C, María Díaz-Zuluaga A, Du Plessis S, Duran F, Fittipaldi S, Fornito A, Freimer N, Gadelha A, Gama C, Garani R, Garcia-Rizo C, Gonzalez Campo C, Gonzalez-Valderrama A, Guinjoan S, Holla B, Ibañez A, Ivanovic D, Jackowski A, Leon-Ortiz P, Lochner C, López-Jaramillo C, Luckhoff H, Massuda R, McGuire P, Miyata J, Mizrahi R, Murray R, Ozerdem A, Pan P, Parellada M, Phahladira L, Ramirez-Mahaluf J, Reckziegel R, Reis Marques T, Reyes-Madrigal F, Roos A, Rosa P, Salum G, Scheffler F, Schumann G, Serpa M, Stein D, Tepper A, Tiego J, Ueno T, Undurraga J, Undurraga E, Valdes-Sosa P, Valli I, Villarreal M, Winton-Brown T, Yalin N, Zamorano F, Zanetti M, Winkler A, Pine D, Evans-Lacko S, Crossley N. Country-level gender inequality is associated with structural differences in the brains of women and men. Proc Natl Acad Sci U S A 2023; 120:e2218782120. [PMID: 37155867 PMCID: PMC10193926 DOI: 10.1073/pnas.2218782120] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/15/2023] [Indexed: 05/10/2023] Open
Abstract
Gender inequality across the world has been associated with a higher risk to mental health problems and lower academic achievement in women compared to men. We also know that the brain is shaped by nurturing and adverse socio-environmental experiences. Therefore, unequal exposure to harsher conditions for women compared to men in gender-unequal countries might be reflected in differences in their brain structure, and this could be the neural mechanism partly explaining women's worse outcomes in gender-unequal countries. We examined this through a random-effects meta-analysis on cortical thickness and surface area differences between adult healthy men and women, including a meta-regression in which country-level gender inequality acted as an explanatory variable for the observed differences. A total of 139 samples from 29 different countries, totaling 7,876 MRI scans, were included. Thickness of the right hemisphere, and particularly the right caudal anterior cingulate, right medial orbitofrontal, and left lateral occipital cortex, presented no differences or even thicker regional cortices in women compared to men in gender-equal countries, reversing to thinner cortices in countries with greater gender inequality. These results point to the potentially hazardous effect of gender inequality on women's brains and provide initial evidence for neuroscience-informed policies for gender equality.
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Affiliation(s)
- André Zugman
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch (E & D), National Institute of Mental Health, National Institutes of Health, BethesdaMD20894
| | - Luz María Alliende
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago8330077, Chile
- Department of Psychology, Northwestern University, Evanston, IL60208
| | - Vicente Medel
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago7941169, Chile
| | - Richard A.I. Bethlehem
- Autism Research Centre, Department of Psychiatry, University of Cambridge, CambridgeCB2 8AH, United Kingdom
- Department of Psychology, University of Cambridge, CambridgeCB2 3EB, United Kingdom
| | - Jakob Seidlitz
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA19104
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children’s Hospital of Philadelphia, Philadelphia, PA19104
- Penn-Children’s Hospital of Philadelphia Lifespan Brain Institute, University of Pennsylvania, Philadelphia, PA19104
| | - Grace Ringlein
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch (E & D), National Institute of Mental Health, National Institutes of Health, BethesdaMD20894
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), School of Medicine, Universidad Complutense, Madrid28009, Spain
| | - Aurina Arnatkevičiūtė
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC3168, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, VIC3168, Australia
| | - Laila Asmal
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town7602, South Africa
| | - Mark Bellgrove
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC3168, Australia
| | - Vivek Benegal
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka560029, India
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Institut d’Investigacions Biomèdiques, August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Barcelona08036, Spain
| | - Pablo Billeke
- Laboratorio de Neurociencia Social y Neuromodulación, Centro de Investigación en Complejidad Social (neuroCICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago7610658, Chile
| | - Jorge Bosch-Bayard
- McGill Centre for Integrative Neuroscience, Ludmer Centre for Neuroinformatics and Mental Health, Montreal Neurological Institute, Montreal, QCH3A 2B4, Canada
- McGill University, Montreal, QCH3A 2B4, Canada
| | - Rodrigo Bressan
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Federal University of São Paulo, São Paulo04039-032, Brazil
| | - Geraldo F. Busatto
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo05403-903, Brazil
| | - Mariana N. Castro
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta (INAAC), Fleni-Consejo Nacional de Investigaciones Científicas y Técnicas Neurosciences Institute (INEU), Ciudad Autónoma de Buenos AiresC1428, Argentina
- Department of Psychiatry and Mental Health, School of Medicine, University of Buenos Aires, Ciudad Autónoma de Buenos AiresC1114AAD, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos AiresC1033AAJ, Argentina
| | - Tiffany Chaim-Avancini
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas, Faculdade de Medicina Universidade de São Paulo (HCFMUSP), Faculdade de Medicina Universidade de São Paulo, São PauloSP05403-903, Brazil
| | - Albert Compte
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona08036, Spain
| | - Monise Costanzi
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto AlegreRS90035-007, Brazil
| | - Leticia Czepielewski
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto AlegreRS90035-007, Brazil
- Programa de Pós-Graduação em Psicologia, Instituto Psicologia, Universidade Federal do Rio Grande do Sul, Porto AlegreRS90040-060, Brazil
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
| | - Camilo de la Fuente-Sandoval
- Laboratory of Experimental Psychiatry, Direction of Research, Instituto Nacional de Neurología y Neurocirugía, Mexico City14269, Mexico
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
- National Institute for Health Research (NIHR), Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King’s College London, LondonSE5 8AZ, United Kingdom
| | - Covadonga M. Díaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), School of Medicine, Universidad Complutense, Madrid28009, Spain
| | - Ana María Díaz-Zuluaga
- Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín050011, Colombia
- Center for Neurobehavioral Genetics, Jane and Terry Semel Institute for Neuroscience and Human Behavior Los Angeles, University of California Los Angeles (UCLA), Los Angeles, CA90024
| | - Stefan Du Plessis
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town7602, South Africa
- South African Medical Research Council (SA MRC), Genomics of Brain Disorders Unit, Cape Town7505, South Africa
| | - Fabio L. S. Duran
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas, Faculdade de Medicina Universidade de São Paulo (HCFMUSP), Faculdade de Medicina Universidade de São Paulo, São PauloSP05403-903, Brazil
| | - Sol Fittipaldi
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago7941169, Chile
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Victoria, Ciudad Autónoma de Buenos AiresB1644BID, Argentina
- Global Brain Health Institute (GBHI), Trinity College Dublin (TCD), DublinDO2 PN40, Ireland
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA94158
| | - Alex Fornito
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC3168, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, VIC3168, Australia
| | - Nelson B. Freimer
- Center for Neurobehavioral Genetics, Jane and Terry Semel Institute for Neuroscience and Human Behavior Los Angeles, University of California Los Angeles (UCLA), Los Angeles, CA90024
| | - Ary Gadelha
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Federal University of São Paulo, São Paulo04039-032, Brazil
| | - Clarissa S. Gama
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto AlegreRS90035-007, Brazil
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clinicas de Porto Alegre, Porto Alegre, RS90035903, Brazil
| | - Ranjini Garani
- Integrated Program in Neuroscience, McGill University, Montreal, QuebecH3A 1A12B4Canada
| | - Clemente Garcia-Rizo
- Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Institut d’Investigacions Biomèdiques, August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Barcelona08036, Spain
| | - Cecilia Gonzalez Campo
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos AiresC1033AAJ, Argentina
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Victoria, Ciudad Autónoma de Buenos AiresB1644BID, Argentina
| | - Alfonso Gonzalez-Valderrama
- Early Intervention Program, Instituto Psiquiátrico Dr. J. Horwitz Barak, Santiago8431621, Chile
- School of Medicine, Universidad Finis Terrae, Santiago7501015, Chile
| | - Salvador Guinjoan
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos AiresC1033AAJ, Argentina
- Laureate Institute for Brain Research, Tulsa, OK74136
| | - Bharath Holla
- Department of Integrative Medicine, NIMHANS, Bengaluru, Karnataka560029, India
- Accelerator Program for Discovery in Brain disorders using Stem cells, Department of Psychiatry, NIMHANS, Bengaluru, Karnataka560029, India
| | - Agustín Ibañez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago7941169, Chile
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos AiresC1033AAJ, Argentina
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Victoria, Ciudad Autónoma de Buenos AiresB1644BID, Argentina
- Global Brain Health Institute (GBHI), Trinity College Dublin (TCD), DublinDO2 PN40, Ireland
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA94158
| | - Daniza Ivanovic
- Laboratorio de Neurociencia Social y Neuromodulación, Centro de Investigación en Complejidad Social (neuroCICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago7610658, Chile
| | - Andrea Jackowski
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo04038-000, Brazil
- Department of Education, Information and Communications Technology (ICT) and Learning, Østfold University College, Halden1757, Norway
| | - Pablo Leon-Ortiz
- Laboratory of Experimental Psychiatry, Direction of Research, Instituto Nacional de Neurología y Neurocirugía, Mexico City14269, Mexico
| | - Christine Lochner
- South African Medical Research Council (SA MRC) Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch7505, South Africa
| | - Carlos López-Jaramillo
- Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín050011, Colombia
| | - Hilmar Luckhoff
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town7602, South Africa
| | - Raffael Massuda
- Department of Psychiatry, Universidade Federal do Paraná (UFPR), CuritibaPR 80060-000, Brazil
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, OxfordOX3 7JX, United Kingdom
- Wellcome Centre for Integrative Neuroimaging (WIN), University of Oxford, OxfordOX3 9DU, United Kingdom
- NIHR Oxford Health Biomedical Research Centre, OxfordOX3 7JX, United Kingdom
- Oxford HealthNational Health Service (NHS), Foundation Trust, OxfordOX4 4XN, United Kingdom
| | - Jun Miyata
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto606-8507, Japan
| | - Romina Mizrahi
- Integrated Program in Neuroscience, McGill University, Montreal, QuebecH3A 1A12B4Canada
- Clinical and Translational Sciences Lab, McGill University, Douglas Mental Health University Institute, Montreal, QCH4A 1R3, Canada
- Department of Psychiatry, McGill University,Montreal, QCH3A 1A1, Canada
| | - Robin Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
| | - Aysegul Ozerdem
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MinnesotaMN55905
| | - Pedro M. Pan
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Federal University of São Paulo, São Paulo04039-032, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo04038-000, Brazil
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), School of Medicine, Universidad Complutense, Madrid28009, Spain
| | - Lebogan Phahladira
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town7602, South Africa
| | - Juan P. Ramirez-Mahaluf
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago8330077, Chile
| | - Ramiro Reckziegel
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto AlegreRS90035-007, Brazil
| | - Tiago Reis Marques
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
| | - Francisco Reyes-Madrigal
- Laboratory of Experimental Psychiatry, Direction of Research, Instituto Nacional de Neurología y Neurocirugía, Mexico City14269, Mexico
| | - Annerine Roos
- South African Medical Research Council (SA MRC) Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town7925, South Africa
| | - Pedro Rosa
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas, Faculdade de Medicina Universidade de São Paulo (HCFMUSP), Faculdade de Medicina Universidade de São Paulo, São PauloSP05403-903, Brazil
| | - Giovanni Salum
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clinicas de Porto Alegre, Porto Alegre, RS90035903, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo04038-000, Brazil
| | - Freda Scheffler
- South African Medical Research Council (SA MRC) Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town7925, South Africa
| | - Gunter Schumann
- Centre for Population Neuroscience and Stratified Medicine (PONS), Institute for Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai200433, China
- PONS-Centre, Charité Mental Health, Dept of Psychiatry and Psychotherapy, Charité Campus Mitte, Berlin10117, Germany
| | - Mauricio Serpa
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo05403-903, Brazil
| | - Dan J. Stein
- South African Medical Research Council (SA MRC) Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town7925, South Africa
| | - Angeles Tepper
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago8330077, Chile
| | - Jeggan Tiego
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC3168, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, VIC3168, Australia
| | - Tsukasa Ueno
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto606-8507, Japan
- Integrated Clinical Education Center, Kyoto University Hospital, Kyoto606-8397, Japan
| | - Juan Undurraga
- Early Intervention Program, Instituto Psiquiátrico Dr. J. Horwitz Barak, Santiago8431621, Chile
- Department of Neurology and Psychiatry, Faculty of Medicine, Clínica Alemana Universidad del DesarrolloVitacura, Santiago7650568, Chile
| | - Eduardo A. Undurraga
- Escuela de Gobierno, Pontificia Universidad Católica de Chile, Santiago7820436, Chile
- Research Center for Integrated Disaster Risk Management (CIGIDEN), Santiago7820436, Chile
- Canadian Institute for Advanced Research (CIFAR), Azrieli Global Scholars Program, CIFAR, Toronto, ONM5G 1M1, Canada
| | - Pedro Valdes-Sosa
- The Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu610054, China
- Centro de Neurociencias de Cuba, La Habana11600, Cuba
| | - Isabel Valli
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona08036, Spain
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
| | - Mirta Villarreal
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta (INAAC), Fleni-Consejo Nacional de Investigaciones Científicas y Técnicas Neurosciences Institute (INEU), Ciudad Autónoma de Buenos AiresC1428, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos AiresC1033AAJ, Argentina
- Department of Physics, Universidad de Buenos Aires, Ciudad Autónoma deBuenos AiresC1428EGA, Argentina
| | - Toby T. Winton-Brown
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC3004, Australia
- Department of Psychiatry, Alfred Health, Melbourne, VIC3004, Australia
| | - Nefize Yalin
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
- South London and Maudsley National Health Service (NHS), Foundation Trust, LondonSE5 8AZ, United Kingdom
| | - Francisco Zamorano
- Unidad de Imágenes Cuantitativas Avanzadas, Departamento de Imágenes, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago7650568, Chile
- Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Santiago7510602, Chile
| | - Marcus V. Zanetti
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas, Faculdade de Medicina Universidade de São Paulo (HCFMUSP), Faculdade de Medicina Universidade de São Paulo, São PauloSP05403-903, Brazil
- Hospital Sírio-Libanês, São Paulo01308-050, Brazil
| | | | - Anderson M. Winkler
- Department of Human Genetics, University of Texas Rio Grande Valley, Brownsville, Texas TX78520
| | - Daniel S. Pine
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch (E & D), National Institute of Mental Health, National Institutes of Health, BethesdaMD20894
| | - Sara Evans-Lacko
- Care Policy and Evaluation Centre, School of Economics and Political Science, LondonWC2A 2AE, United Kingdom
| | - Nicolas A. Crossley
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago8330077, Chile
- Department of Psychiatry, University of Oxford, OxfordOX3 7JX, United Kingdom
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Cunha GR, Caye A, Pan P, Fisher HL, Pereira R, Ziebold C, Bressan R, Miguel EC, Salum GA, Rohde LA, Kohrt BA, Mondelli V, Kieling C, Gadelha A. Identifying Depression Early in Adolescence: assessing the performance of a risk score for future onset of depression in an independent Brazilian sample. Braz J Psychiatry 2023; 45:242-248. [PMID: 37126861 PMCID: PMC10288471 DOI: 10.47626/1516-4446-2022-2775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 03/23/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE The Identifying Depression Early in Adolescence Risk Score (IDEA-RS) was recently developed in Brazil using data from the Pelotas 1993 Birth Cohort to estimate the individualized probability of developing depression in adolescence. This model includes 11 sociodemographic variables and has been assessed in longitudinal studies from four other countries. We aimed to test the performance of IDEA-RS in an independent, community-based, school-attending sample within the same country: the Brazilian High-Risk Cohort. METHODS Standard external validation, refitted, and case mix-corrected models were used to predict depression among 1442 youth followed from a mean age of 13.5 years at baseline to 17.7 years at follow-up, using probabilities calculated with IDEA-RS coefficients. RESULTS The area under the curve was 0.65 for standard external validation, 0.70 for the case mix-corrected model, and 0.69 for the refitted model, with discrimination consistently above chance for predicting depression in the new dataset. There was some degree of miscalibration, corrected by model refitting (calibration-in-the-large reduced from 0.77 to 0). CONCLUSION IDEA-RS was able to parse individuals with higher or lower probability of developing depression beyond chance in an independent Brazilian sample. Further steps should include model improvements and additional studies in populations with high levels of subclinical symptoms to improve clinical decision making.
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Affiliation(s)
- Graccielle R. Cunha
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Departamento de Psiquiatria, UNIFESP, São Paulo, SP, Brazil
| | - Arthur Caye
- Instituto Nacional de Ciência e Tecnologia de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), São Paulo, SP, Brazil
- Departamento de Psiquiatria, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Serviço de Psiquiatria da Infância e Adolescência, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Pedro Pan
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Departamento de Psiquiatria, UNIFESP, São Paulo, SP, Brazil
- Instituto Nacional de Ciência e Tecnologia de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), São Paulo, SP, Brazil
| | - Helen L. Fisher
- King’s College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
- ESRC Centre for Society and Mental Health, King’s College London, London, United Kingdom
| | - Rivka Pereira
- Departamento de Psiquiatria, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Serviço de Psiquiatria da Infância e Adolescência, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Carolina Ziebold
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Departamento de Psiquiatria, UNIFESP, São Paulo, SP, Brazil
| | - Rodrigo Bressan
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Eurípedes Constantino Miguel
- Instituto Nacional de Ciência e Tecnologia de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), São Paulo, SP, Brazil
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Giovanni A. Salum
- Instituto Nacional de Ciência e Tecnologia de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), São Paulo, SP, Brazil
- Departamento de Psiquiatria, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Child Mind Institute, New York, NY, USA
| | - Luis Augusto Rohde
- Instituto Nacional de Ciência e Tecnologia de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), São Paulo, SP, Brazil
- ADHD Outpatient Program & Developmental Psychiatry Program, HCPA, UFRGS, Porto Alegre, RS, Brazil
- Grupo UniEduK, Brazil
| | - Brandon A. Kohrt
- Division of Global Mental Health, Department of Psychiatry, School of Medicine and Health Sciences, The George Washington University, Washington, DC, United States
| | - Valeria Mondelli
- Institute of Psychiatry, Psychology, & Neuroscience, Department of Psychological Medicine, King’s College London, London, United Kingdom
- National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King’s College London, London, United Kingdom
| | - Christian Kieling
- Departamento de Psiquiatria, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Serviço de Psiquiatria da Infância e Adolescência, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Ary Gadelha
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Departamento de Psiquiatria, UNIFESP, São Paulo, SP, Brazil
- Instituto Nacional de Ciência e Tecnologia de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), São Paulo, SP, Brazil
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10
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Leffa DT, Caye A, Belangero SI, Gadelha A, Pan PM, Salum GA, Rohde LA. The synergistic effect of genetic and environmental factors in the development of attention-deficit/hyperactivity disorder symptoms in children and adolescents. Dev Psychopathol 2023:1-11. [PMID: 37092659 DOI: 10.1017/s0954579423000366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
Gene-environment interactions (GxE) have been increasingly explored in psychiatry but with low replication rates. Attention-deficit/hyperactivity disorder (ADHD) is a suitable candidate for studying GxE due to its high heritability and well-defined environmental risk factors. Here, we explored GxE using polygenic risk score (PRS) to represent the genetic liability to ADHD (ADHD-PRS) and environmental risk score (ERS) to represent the combined effects of environmental risk factors. We analyzed longitudinal data of 2,046 individuals (6-14 years of age at baseline and 14-23 at the last follow-up) from the Brazilian High-Risk Cohort Study for Psychiatric Disorders. Psychiatric evaluation included the Child Behavior Checklist and the Strength and Difficulties Questionnaire. Statistical analyses were performed using mixed-effects models. We observed statistically significant interactions between ADHD-PRS and ERS, suggesting that environmental and genetic factors act synergistically in the development of ADHD symptoms. These effects were not present for depression or anxiety symptoms. No evidence of GxE correlation was detected. Mechanistically, our findings suggest that environmental stressors modulate the genetic risk for ADHD. Future studies should investigate whether the reduction of environmental risks can prevent the development of symptoms of ADHD, especially in children with a family history of the disorder.
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Affiliation(s)
- Douglas Teixeira Leffa
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Arthur Caye
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Sintia I Belangero
- Genetics Division, Department of Morphology and Genetics, Universidade Federal de São Paulo, São Paulo, Brazil
- Laboratory of Integrative Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ary Gadelha
- Laboratory of Integrative Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Pedro Mario Pan
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
| | - Giovanni Abrahão Salum
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Section on Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Luis Augusto Rohde
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Advisory council, Medical School, UNIEDUK, Indaiatuba, Brazil
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11
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Barbosa MG, Machado V, Ziebold C, Moriyama T, Bressan RA, Pan P, Rohde LA, Miguel EC, Fonseca L, Van Os J, Gadelha A. Longitudinal invariance of psychotic experiences in children and adolescents: What do the data tell us? Schizophr Res 2023; 255:33-40. [PMID: 36958268 DOI: 10.1016/j.schres.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 01/09/2023] [Accepted: 03/03/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND Psychotic experiences are common in adults, adolescents, and children. While usually self-limited, they can indicate psychosis proneness when persistent. The Community Assessment of Psychic Experiences (CAPE) measures lifetime psychotic experiences in three dimensions. The 20-item subscale addressing positive symptoms (CAPE-positive) is the most widely used. No study investigated its measurement invariance across timepoints during childhood and adolescence. This step is required to conduct reliable comparisons in longitudinal studies with different age groups. METHODS We used data from the Brazilian High-Risk Cohort, which enrolled 2511 individuals aged 6-12 years from public schools for the baseline evaluation. A 3-year follow-up assessment evaluated 1880 participants. Subjects were rated with the CAPE-positive and we performed, at each wave, a Multigroup Confirmatory Factor Analysis testing Exploratory and Confirmatory Factor Analysis models identified in a previous systematic review, to assess longitudinal invariance. RESULTS A three-factor solution was the best fitting model, comprising Persecutory Ideation, Bizarre Experiences and Perceptual Abnormalities. The longitudinal invariance analysis of the best-fit model was unsatisfactory, achieving only the metric level of invariance. CONCLUSIONS Our findings suggest that the CAPE-positive scale has good model fit indices for each evaluated time point individually (children and adolescents), but it is not invariant over time. Identifying which factors affect CAPE latent structure at different time points can improve our understanding of psychosis proneness and how to measure it.
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Affiliation(s)
- Matheus Ghossain Barbosa
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de Sao Paulo, Rua Major Maragliano, 241, Sao Paulo, SP CEP 04017-030, Brazil.
| | - Viviane Machado
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de Sao Paulo, Rua Major Maragliano, 241, Sao Paulo, SP CEP 04017-030, Brazil
| | - Carolina Ziebold
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de Sao Paulo, Rua Major Maragliano, 241, Sao Paulo, SP CEP 04017-030, Brazil
| | - Tais Moriyama
- Bairral Institute of Psychiatry, R. Dr. Hortencio Pereira da Silva, 313, Vila Pereira, Itapira, SP CEP 13970-905, Brazil
| | - Rodrigo A Bressan
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de Sao Paulo, Rua Major Maragliano, 241, Sao Paulo, SP CEP 04017-030, Brazil; Schizophrenia Program (PROESQ), Department of Psychiatry, Universidade Federal de Sao Paulo, Rua Major Maragliano, 241, Sao Paulo, SP CEP 04017-030, Brazil
| | - Pedro Pan
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de Sao Paulo, Rua Major Maragliano, 241, Sao Paulo, SP CEP 04017-030, Brazil
| | - Luis Augusto Rohde
- Attention Deficit and Hyperactivity Disorder (ADHD) Outpatient and Developmental Psychiatry Programs, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Av. Protasio Alves, 211 - Santa Cecilia, Porto Alegre, RS CEP 90035-903, Brazil
| | - Euripedes Constantino Miguel
- Institute of Psychiatry (IPQ), Universidade de Sao Paulo, Rua Dr. Ovidio Pires de Campos, 785, Sao Paulo, SP CEP 05403-903, Brazil
| | - Lais Fonseca
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de Sao Paulo, Rua Major Maragliano, 241, Sao Paulo, SP CEP 04017-030, Brazil; Schizophrenia Program (PROESQ), Department of Psychiatry, Universidade Federal de Sao Paulo, Rua Major Maragliano, 241, Sao Paulo, SP CEP 04017-030, Brazil
| | - Jim Van Os
- Universitair Medisch Centrum Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - Ary Gadelha
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de Sao Paulo, Rua Major Maragliano, 241, Sao Paulo, SP CEP 04017-030, Brazil; Schizophrenia Program (PROESQ), Department of Psychiatry, Universidade Federal de Sao Paulo, Rua Major Maragliano, 241, Sao Paulo, SP CEP 04017-030, Brazil
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12
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Hird EJ, Ohmuro N, Allen P, Moseley P, Kempton MJ, Modinos G, Sachs G, van der Gaag M, de Haan L, Gadelha A, Bressan R, Barrantes-Vidal N, Ruhrmann S, Catalan A, McGuire P. Speech Illusions in People at Clinical High Risk for Psychosis Linked to Clinical Outcome. Schizophr Bull 2023; 49:339-349. [PMID: 36516396 PMCID: PMC10016413 DOI: 10.1093/schbul/sbac163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND HYPOTHESIS Around 20% of people at clinical high risk (CHR) for psychosis later develop a psychotic disorder, but it is difficult to predict who this will be. We assessed the incidence of hearing speech (termed speech illusions [SIs]) in noise in CHR participants and examined whether this was associated with adverse clinical outcomes. STUDY DESIGN At baseline, 344 CHR participants and 67 healthy controls were presented with a computerized white noise task and asked whether they heard speech, and whether speech was neutral, affective, or whether they were uncertain about its valence. After 2 years, we assessed whether participants transitioned to psychosis, or remitted from the CHR state, and their functioning. STUDY RESULTS CHR participants had a lower sensitivity to the task. Logistic regression revealed that a bias towards hearing targets in stimuli was associated with remission status (OR = 0.21, P = 042). Conversely, hearing SIs with uncertain valence at baseline was associated with reduced likelihood of remission (OR = 7.72. P = .007). When we assessed only participants who did not take antipsychotic medication at baseline, the association between hearing SIs with uncertain valence at baseline and remission likelihood remained (OR = 7.61, P = .043) and this variable was additionally associated with a greater likelihood of transition to psychosis (OR = 5.34, P = .029). CONCLUSIONS In CHR individuals, a tendency to hear speech in noise, and uncertainty about the affective valence of this speech, is associated with adverse outcomes. This task could be used in a battery of cognitive markers to stratify CHR participants according to subsequent outcomes.
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Affiliation(s)
- Emily J Hird
- To whom correspondence should be addressed; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, SE5 8AF, London, UK; e-mail:
| | | | - Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- School of Psychology, Whitelands College, University of Roehampton, Holybourne Ave, London, SW15 4JD, UK
| | - Peter Moseley
- Psychology Department, Northumbria University, College Lane, Newcastle-Upon-Tyne, NE1 8ST, UK
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Mark van der Gaag
- Faculty of Behavioural and Movement Sciences, Department of Clinical Psychology, VU University, van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
- EMGO Institute for Health and Care Research, VU University, van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
- Department of Psychosis Research, Parnassia Psychiatric Institute, Zoutkeetsingel 40, 2512 HN The Hague, The Netherlands
| | - Lieuwe de Haan
- Department Early Psychosis, AMC, Academic Psychiatric Centre, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands
- Arkin, Amsterdam, The Netherlands
| | - Ary Gadelha
- LiNC - Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP, São Paulo, Brazil
| | - Rodrigo Bressan
- LiNC - Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP, São Paulo, Brazil
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Fundació Sanitària Sant Pere Claver (Spain), Spanish Mental Health Research Network (CIBERSAM), Barcelona, Spain
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Ana Catalan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Psychiatry Department, Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto, Facultad de Medicina y Odontología, University of the Basque Country UPV/EHU, Centro de Investigación en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Plaza de Cruces 12, 48903 Barakaldo, Bizkaia, Spain
| | - EU-GEI High Risk Study
McGuirePhilipDepartment of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, Denmark 458 Hill, London, SE5 8AF, UKValmaggiaLucia RDepartment of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, 456, London, SE5 8AF, UKKemptonMatthew JDepartment of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, Denmark 458 Hill, London, SE5 8AF, UKCalemMariaDepartment of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, Denmark 458 Hill, London, SE5 8AF, UKTogninStefaniaDepartment of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, Denmark 458 Hill, London, SE5 8AF, UKModinosGemmaDepartment of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, Denmark 458 Hill, London, SE5 8AF, UKde HaanLieuweDepartment Early Psychosis, AMC, Academic Psychiatric Centre, Meibergdreef 5, 1105 AZ Amsterdam, The NetherlandsArkin, Amsterdam, The Netherlandsvan der GaagMarkFaculty of Behavioural and Movement Sciences, Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University, van der Boechorststraat 1, 1081 BT Amsterdam, The NetherlandsDepartment of Psychosis Research, Parnassia Psychiatric Institute, Zoutkeetsingel 40, 2512 HN The Hague, The NetherlandsVelthorstEvaDepartment Early Psychosis, AMC, Academic Psychiatric Centre, Meibergdreef 5, 1105 AZ Amsterdam, The NetherlandsDepartment of Psychiatry, Icahn School of Medicine at Mount Sinai, 1425 Madison Ave, New York, NY 10029, USAKraanTamar CDepartment Early Psychosis, AMC, Academic Psychiatric Centre, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlandsvan DamDaniella SDepartment Early Psychosis, AMC, Academic Psychiatric Centre, Meibergdreef 5, 1105 AZ Amsterdam, The NetherlandsBurgerNadineDepartment of Psychosis Research, Parnassia Psychiatric Institute, Zoutkeetsingel 40, 2512 HN The Hague, The NetherlandsNelsonBarnabyCentre for Youth Mental Health, University of Melbourne, 35 Poplar Road (Locked Bag 10), Parkville, Victoria 485 3052, AustraliaMcGorryPatrickCentre for Youth Mental Health, University of Melbourne, 35 Poplar Road (Locked Bag 10), Parkville, Victoria 485 3052, AustraliaPaul AmmingerGünterCentre for Youth Mental Health, University of Melbourne, 35 Poplar Road (Locked Bag 10), Parkville, Victoria 485 3052, AustraliaPantelisChristosCentre for Youth Mental Health, University of Melbourne, 35 Poplar Road (Locked Bag 10), Parkville, Victoria 485 3052, AustraliaPolitisAthenaCentre for Youth Mental Health, University of Melbourne, 35 Poplar Road (Locked Bag 10), Parkville, Victoria 485 3052, AustraliaGoodallJoanneCentre for Youth Mental Health, University of Melbourne, 35 Poplar Road (Locked Bag 10), Parkville, Victoria 485 3052, AustraliaRiecher-RösslerAnitaUniversity Psychiatric Hospital, Wilhelm Klein-Strasse 27, CH-4002 Basel, SwitzerlandBorgwardtStefanUniversity Psychiatric Hospital, Wilhelm Klein-Strasse 27, CH-4002 Basel, SwitzerlandRappCharlotteUniversity Psychiatric Hospital, Wilhelm Klein-Strasse 27, CH-4002 Basel, SwitzerlandIttigSarahUniversity Psychiatric Hospital, Wilhelm Klein-Strasse 27, CH-4002 Basel, SwitzerlandStuderusErichUniversity Psychiatric Hospital, Wilhelm Klein-Strasse 27, CH-4002 Basel, SwitzerlandSmieskovaRenataUniversity Psychiatric Hospital, Wilhelm Klein-Strasse 27, CH-4002 Basel, SwitzerlandBressanRodrigoLiNC - Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP, São Paulo, BrazilGadelhaAryLiNC - Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP, São Paulo, BrazilBrietzkeElisaDepto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP, São Paulo, BrazilAsevedoGraccielleLiNC - Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP, São Paulo, BrazilAsevedoElsonLiNC - Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP, São Paulo, BrazilZugmanAndreLiNC - Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP, São Paulo, BrazilBarrantes-VidalNeusDepartament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Fundació Sanitària Sant Pere Claver (Spain), Spanish Mental Health Research Network (CIBERSAM), Barcelona, SpainDomínguez-MartínezTecelliCONACYT-Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz (México), Mexico City, MexicoTorrecillaPilarDepartament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Barcelona, SpainKwapilThomas RDepartment of Psychology, University of Illinois at Urbana-Champaign, IL, USAMonsonetManelDepartament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Barcelona, SpainHinojosaLídiaDepartament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Barcelona, SpainKazesMathildeUniversity Paris Descartes, Hôpital Sainte-Anne, C’JAAD, Service HospitaloUniversitaire, Inserm U894, Institut de Psychiatrie (CNRS 3557) Paris, FranceDabanClaireUniversity Paris Descartes, Hôpital Sainte-Anne, C’JAAD, Service HospitaloUniversitaire, Inserm U894, Institut de Psychiatrie (CNRS 3557) Paris, FranceBourginJulieUniversity Paris Descartes, Hôpital Sainte-Anne, C’JAAD, Service HospitaloUniversitaire, Inserm U894, Institut de Psychiatrie (CNRS 3557) Paris, FranceGayOlivierUniversity Paris Descartes, Hôpital Sainte-Anne, C’JAAD, Service HospitaloUniversitaire, Inserm U894, Institut de Psychiatrie (CNRS 3557) Paris, FranceMam-Lam-FookCéliaUniversity Paris Descartes, Hôpital Sainte-Anne, C’JAAD, Service HospitaloUniversitaire, Inserm U894, Institut de Psychiatrie (CNRS 3557) Paris, FranceKrebsMarie-OdileUniversity Paris Descartes, Hôpital Sainte-Anne, C’JAAD, Service HospitaloUniversitaire, Inserm U894, Institut de Psychiatrie (CNRS 3557) Paris, FranceNordholmDorteMental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Copenhagen, DenmarkRandersLasseMental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Copenhagen, DenmarkKrakauerKristineMental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Copenhagen, DenmarkGlenthøjLouiseMental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Copenhagen, DenmarkGlenthøjBirteCentre for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, DenmarkNordentoftMereteMental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Copenhagen, DenmarkRuhrmannStephanDepartment of Psychiatry and Psychotherapy, University of Cologne, Cologne, GermanyGebhardDominikaDepartment of Psychiatry and Psychotherapy, University of Cologne, Cologne, GermanyArnholdJuliaPsyberlin, Berlin, GermanyKlosterkötterJoachimDepartment of Psychiatry and Psychotherapy, University of Cologne, Cologne, GermanySachsGabrieleDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, AustriaLasserIrisDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, AustriaWinklbaurBernadetteDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, AustriaDelespaulPhilippe ADepartment of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, PO Box 616, 6200 MD 464 Maastricht, The NetherlandsMondriaan Mental Health Trust, PO Box 4436 CX Heerlen, The NetherlandsRuttenBart PDepartment of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, PO Box 616, 6200 MD 464 Maastricht, The Netherlandsvan Os1JimDepartment of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, PO Box 616, 6200 MD 464 Maastricht, The Netherlands
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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13
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Roza TH, Rabelo-da-Ponte FD, Spritzer DT, Hoffmann MS, Massuda R, Salum GA, Miguel EC, Rohde LA, Pan PM, Kessler FHP, Gadelha A, Passos IC. Depression in mothers at childhood: Direct and indirect association with problematic gaming in late adolescence/young adulthood. J Psychiatr Res 2023; 159:14-21. [PMID: 36652752 DOI: 10.1016/j.jpsychires.2023.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 12/06/2022] [Accepted: 01/10/2023] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Little is known about the relationship between depression in mothers and problematic gaming in their children. Therefore, we aimed to investigate the potential role of mothers' depression in childhood as a risk factor for problematic gaming in their offspring in late adolescence/young adulthood. METHODS We assessed data from 1557 participants on three waves (T0 collected in 2010/2011, T1 in 2013/2014, and T2 in 2018/2019) of a large Brazilian school-based cohort. Mother's depression at T0 was tested as a predictor of problematic gaming at T2 in a logistic regression model. In mediation analyses, we individually assessed internalizing or externalizing disorders at T1 as mediators in this association, with participants' sex being tested as a moderator in both models. Inverse probability weights were used to account for sample attrition at T2. All models were adjusted for maternal and participant-related covariates. RESULTS Mother's depression at T0 was significantly associated with problematic gaming at T2 (OR = 2.09, p < 0.001) even after adjusting for multiple confounding factors. The presence of any internalizing disorder at T1 was a partial mediator of this relationship, accounting for 8.18% (p = 0.032) of the total effect, while the presence of any externalizing disorder at T1 was not a significant mediator. Participants' sex was not a significant moderator in mediation models. CONCLUSIONS These findings suggest mother's depression in childhood as a risk factor for problematic gaming in later developmental stages, which may be partially mediated by internalizing psychopathology.
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Affiliation(s)
- Thiago Henrique Roza
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
| | - Francisco Diego Rabelo-da-Ponte
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
| | - Daniel Tornaim Spritzer
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
| | - Maurício Scopel Hoffmann
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Department of Neuropsychiatry, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil; Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom; Instituto Nacional de Psiquiatria do Desenvolvimento (INPD), São Paulo, SP, Brazil.
| | - Raffael Massuda
- Department of Psychiatry, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.
| | - Giovanni Abrahão Salum
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Instituto Nacional de Psiquiatria do Desenvolvimento (INPD), São Paulo, SP, Brazil.
| | - Euripedes Constantino Miguel
- Instituto Nacional de Psiquiatria do Desenvolvimento (INPD), São Paulo, SP, Brazil; Department of Psychiatry, School of Medicine, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
| | - Luis Augusto Rohde
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Instituto Nacional de Psiquiatria do Desenvolvimento (INPD), São Paulo, SP, Brazil; ADHD Outpatient Program & Developmental Psychiatry Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
| | - Pedro Mario Pan
- Instituto Nacional de Psiquiatria do Desenvolvimento (INPD), São Paulo, SP, Brazil; Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil.
| | - Felix Henrique Paim Kessler
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
| | - Ary Gadelha
- Instituto Nacional de Psiquiatria do Desenvolvimento (INPD), São Paulo, SP, Brazil; Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil; Programa de Esquizofrenia (PROESQ), Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil.
| | - Ives Cavalcante Passos
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
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14
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Romani-Sponchiado A, Vidal-Ribas P, Bressan RA, de Jesus Mari J, Miguel EC, Gadelha A, Rohde LAP, Evans-Lacko S, Salum GA, Hoffmann MS. Longitudinal associations between positive attributes and psychopathology and their interactive effects on educational outcomes. Eur Child Adolesc Psychiatry 2023; 32:463-474. [PMID: 34559317 DOI: 10.1007/s00787-021-01882-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 09/15/2021] [Indexed: 11/26/2022]
Abstract
Psychopathology is associated with impaired learning and early termination of schooling, whereas positive attributes are associated with better educational outcomes. However, it is important to understand if and how psychopathology and positive attributes longitudinally impact each other so we could shed light on where to intervene to promote educational outcomes through these constructs. A large prospective school-based community cohort of youths (5-15 years of age, 45% female) were assessed and followed up for 3 years (n = 2010; 80% retention). We assessed the longitudinal impact of positive attributes (Youth Strength Inventory) and psychopathology (bifactor model of Strengths and Difficulties Questionnaire) using a cross-lagged panel model. We also used generalized mixed effects models to investigate how these both constructs predict school dropout and literacy, adjusting for confounders and testing their interaction. Positive attributes negatively predicted, and were negatively predicted by, the general factor of psychopathology and conduct problems in the cross-lagged panel model. Positive attributes (OR = 0.57, 95% CI [0.44, 0.73], p < 0.001) and specific conduct symptoms (OR = 2.33, 95% CI [1.64, 3.33], p < 0.001) predicted school dropout, whereas the general factor of psychopathology predicted lower literacy ability (β = - 0.08, 95% CI [- 0.11, - 0.05], p < 0.001). However, the protective association of positive attributes on school dropout decreases as the general factor of psychopathology increases. These findings provide new evidence that positive attributes and psychopathology mutually influence each other over development and have interactive effects on educational outcomes.
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Affiliation(s)
- Aline Romani-Sponchiado
- Universidade Federal Do Rio Grande Do Sul, Ramiro Barcelos, 2350 - room 2202, Porto Alegre, 90035-003, Brazil.
- Section On Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil.
| | - Pablo Vidal-Ribas
- Social and Behavioral Science Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, USA
| | - Rodrigo Affonseca Bressan
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, SP, Brazil
- Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Jair de Jesus Mari
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, SP, Brazil
- Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Eurípedes Constantino Miguel
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, SP, Brazil
- Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Ary Gadelha
- Laboratory of Integrative Neuroscience (LINC), Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Luis Augusto Paim Rohde
- Universidade Federal Do Rio Grande Do Sul, Ramiro Barcelos, 2350 - room 2202, Porto Alegre, 90035-003, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, SP, Brazil
- ADHD Outpatient Program & Developmental Psychiatry Program, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande Do Sul, Porto Alegre, RS, Brazil
| | - Sara Evans-Lacko
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Giovanni Abrahão Salum
- Universidade Federal Do Rio Grande Do Sul, Ramiro Barcelos, 2350 - room 2202, Porto Alegre, 90035-003, Brazil
- Section On Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, SP, Brazil
| | - Mauricio Scopel Hoffmann
- Universidade Federal Do Rio Grande Do Sul, Ramiro Barcelos, 2350 - room 2202, Porto Alegre, 90035-003, Brazil
- Section On Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, SP, Brazil
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
- Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
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15
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Axelrud LK, Hoffmann MS, Vosberg DE, Santoro M, Pan PM, Gadelha A, Belangero SI, Miguel EC, Shin J, Thapar A, Smoller JW, Pausova Z, Rohde LA, Keller MC, Paus T, Salum GA. Disentangling the influences of parental genetics on offspring's cognition, education, and psychopathology via genetic and phenotypic pathways. J Child Psychol Psychiatry 2023; 64:408-416. [PMID: 36162806 DOI: 10.1111/jcpp.13708] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/24/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Specific pathways of intergenerational transmission of behavioral traits remain unclear. Here, we aim to investigate how parental genetics influence offspring cognition, educational attainment, and psychopathology in youth. METHODS Participants for the discovery sample were 2,189 offspring (aged 6-14 years), 1898 mothers and 1,017 fathers who underwent genotyping, psychiatric, and cognitive assessments. We calculated polygenic scores (PGS) for cognition, educational attainment, attention-deficit hyperactivity disorder (ADHD), and schizophrenia for the trios. Phenotypes studied included educational and cognitive measures, ADHD and psychotic symptoms. We used a stepwise approach and multiple mediation models to analyze the effect of parental PGS on offspring traits via offspring PGS and parental phenotype. Significant results were replicated in a sample of 1,029 adolescents, 363 mothers, and 307 fathers. RESULTS Maternal and paternal PGS for cognition influenced offspring general intelligence and executive function via offspring PGS (genetic pathway) and parental education (phenotypic pathway). Similar results were found for parental PGS for educational attainment and offspring reading and writing skills. These pathways fully explained associations between parental PGS and offspring phenotypes, without residual direct association. Associations with maternal, but not paternal, PGS were replicated. No associations were found between parental PGS for psychopathology and offspring specific symptoms. CONCLUSIONS Our findings indicate that parental genetics influences offspring cognition and educational attainment by genetic and phenotypic pathways, suggesting the expression of parental phenotypes partially explain the association between parental genetic risk and offspring outcomes. Multiple mediations might represent an effective approach to disentangle distinct pathways for intergenerational transmission of behavioral traits.
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Affiliation(s)
- Luiza K Axelrud
- Section on Negative Affect and Social Processes, Department of Psychiatry and Legal Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil
| | - Maurício S Hoffmann
- Section on Negative Affect and Social Processes, Department of Psychiatry and Legal Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil.,Department of Neuropsychiatry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil.,Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Daniel E Vosberg
- Research Institute, Hospital for Sick Children, Toronto, ON, Canada.,Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, QC, Canada
| | - Marcos Santoro
- National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil.,Department of Morphology and Genetics, Universidade Federal de São Paulo, São Paulo, Brazil.,Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Pedro M Pan
- National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil.,Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Ary Gadelha
- National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil.,Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Sintia I Belangero
- National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil.,Department of Morphology and Genetics, Universidade Federal de São Paulo, São Paulo, Brazil.,Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Euripedes C Miguel
- National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil.,Universidade de São Paulo (USP), São Paulo, Brazil
| | - Jean Shin
- Research Institute, Hospital for Sick Children, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Department of Physiology, University of Toronto, Toronto, ON, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Anita Thapar
- Division of Psychological Medicine and Clinical Neurosciences and MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Jordan W Smoller
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Zdenka Pausova
- Research Institute, Hospital for Sick Children, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Department of Physiology, University of Toronto, Toronto, ON, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,ECOGENE-21, Chicoutimi, QC, Canada
| | - Luis A Rohde
- Section on Negative Affect and Social Processes, Department of Psychiatry and Legal Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil.,ADHD Outpatient Program, Department of Psychiatry, Clinical Research Center, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Matthew C Keller
- Department of Microbiology, New York University School of Medicine, New York, NY, USA
| | - Tomáš Paus
- Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, QC, Canada.,ECOGENE-21, Chicoutimi, QC, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Montreal, Montreal, QC, Canada.,Department of Neuroscience, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Giovanni A Salum
- Section on Negative Affect and Social Processes, Department of Psychiatry and Legal Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil
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16
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Dos Santos PMN, Mendes SL, Biazoli C, Gadelha A, Salum GA, Miguel EC, Rohde LA, Sato JR. Assessing atypical brain functional connectivity development: An approach based on generative adversarial networks. Front Neurosci 2023; 16:1025492. [PMID: 36699518 PMCID: PMC9868740 DOI: 10.3389/fnins.2022.1025492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/25/2022] [Indexed: 01/11/2023] Open
Abstract
Generative Adversarial Networks (GANs) are promising analytical tools in machine learning applications. Characterizing atypical neurodevelopmental processes might be useful in establishing diagnostic and prognostic biomarkers of psychiatric disorders. In this article, we investigate the potential of GANs models combined with functional connectivity (FC) measures to build a predictive neurotypicality score 3-years after scanning. We used a ROI-to-ROI analysis of resting-state functional magnetic resonance imaging (fMRI) data from a community-based cohort of children and adolescents (377 neurotypical and 126 atypical participants). Models were trained on data from neurotypical participants, capturing their sample variability of FC. The discriminator subnetwork of each GAN model discriminated between the learned neurotypical functional connectivity pattern and atypical or unrelated patterns. Discriminator models were combined in ensembles, improving discrimination performance. Explanations for the model's predictions are provided using the LIME (Local Interpretable Model-Agnostic) algorithm and local hubs are identified in light of these explanations. Our findings suggest this approach is a promising strategy to build potential biomarkers based on functional connectivity.
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Affiliation(s)
- Pedro Machado Nery Dos Santos
- Center of Mathematics, Computing, and Cognition, Universidade Federal do ABC, São Bernardo do Campo, Santo André, Brazil
| | - Sérgio Leonardo Mendes
- Center of Mathematics, Computing, and Cognition, Universidade Federal do ABC, São Bernardo do Campo, Santo André, Brazil
| | - Claudinei Biazoli
- Center of Mathematics, Computing, and Cognition, Universidade Federal do ABC, São Bernardo do Campo, Santo André, Brazil
| | - Ary Gadelha
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil,National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo, Brazil
| | - Giovanni Abrahão Salum
- National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo, Brazil,Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Euripedes Constantino Miguel
- National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo, Brazil,Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Luis Augusto Rohde
- National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo, Brazil,Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil,UniEduK, Jaguariúna, Brazil
| | - João Ricardo Sato
- Center of Mathematics, Computing, and Cognition, Universidade Federal do ABC, São Bernardo do Campo, Santo André, Brazil,Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil,National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo, Brazil,Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil,*Correspondence: João Ricardo Sato,
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17
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Arcadepani FB, Gadelha A, Margolis RL. Mutation of GPR143 Associated With Ocular Albinism Type 1, Intellectual Disability, and Schizophrenia: The Complex Biological and Social Interactions Between Genetic Syndromes and Mental Illness. J Psychiatr Pract 2023; 29:77-81. [PMID: 36649556 DOI: 10.1097/pra.0000000000000685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Copy number variations, which manifest primarily as deletions and duplications, contribute significantly to the genetic risk of schizophrenia. Specific syndromes associated with copy number variations, exemplified by the 22q11 deletion syndrome, confer both congenital abnormalities and an elevated risk of schizophrenia. We report the case of a patient with a deletion of exons 2 through 8 of GPR143. In addition to having the ophthalmologic disorder ocular albinism type 1 (OA1), a well-established consequence of mutations of GPR143, the patient is also intellectually impaired and impulsive, and he developed schizophrenia at age 15. Psychiatric manifestations of OA1 have not previously been reported, yet remain plausible, as the GPR143 protein is widely distributed in the brain and may function as an L-DOPA receptor. However, the patient described here also had a family history of psychiatric disorders independent of OA1, in utero exposure to heroin and cocaine, and challenging family circumstances. We suggest that the relationship between his GPR143 mutation and his psychiatric disorders is complex. The mutation may have directly contributed to his cognitive and psychiatric disorders, but we also suspect that OA1, present in multiple family members, contributed to multigenerational familial instability. Further, OA1 likely exacerbated our patient's cognitive and social impairment by interfering with his education, while his neuropsychiatric status frequently interfered with the assessment and treatment of his OA1. We conclude that the psychiatric and nonpsychiatric manifestations of a genetic syndrome are best managed in parallel and that psychiatrists and other mental health providers may be in the best position to assure that patients receive appropriate genetic and medical care.
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18
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Lorenzi CH, Teixeira Leffa D, Bressan R, Belangero S, Gadelha A, Santoro ML, Salum GA, Rohde LA, Caye A. Replication of a predictive model for youth ADHD in an independent sample from a developing country. J Child Psychol Psychiatry 2023; 64:167-174. [PMID: 35959538 DOI: 10.1111/jcpp.13682] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/21/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Very few predictive models in Psychiatry had their performance validated in independent external samples. A previously developed multivariable demographic model for attention-deficit/hyperactivity disorder (ADHD) accurately predicted young adulthood ADHD using clinical and demographical information collected in childhood in three samples from developed countries, but failed to replicate its performance in a sample from a developing country. Furthermore, consolidated risk factors for ADHD were not included among its predictors. METHODS Participants were 1905 children and adolescents from a community-based sample and followed from ages 6 to 14 years at baseline to ages 14 to 23 years (mean age 18) at follow-up. We applied the intercept and weights of the original model to the data, calculating the predicted probability of each participant according to the set of predictors collected in childhood, and compared the estimates with the actual outcome (ADHD) collected during adolescence and young adulthood. We explored the performance of the original model, and of models including novel predictors (prematurity, family history of ADHD, and polygenic risk score for ADHD). RESULTS The observed area under the curve of the original model was .76 (95% Confidence Interval .70 to .82). The multivariable demographical model outperformed single variable models using only prematurity, family history, or the ADHD PRS. Adding either of these variables, or all at once, did not improve the performance of the original demographical model. CONCLUSIONS Our findings suggest that the originally developed ADHD predictive model is suitable for use in different settings for clinical and research purposes.
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Affiliation(s)
- Cezar H Lorenzi
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Douglas Teixeira Leffa
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil
| | - Rodrigo Bressan
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil.,Post-Graduation Program in Psychiatry and Medical Psychology, UNIFESP, São Paulo, Brazil
| | - Sintia Belangero
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil.,Post-Graduation Program in Psychiatry and Medical Psychology, UNIFESP, São Paulo, Brazil.,Genetics Division, Department of Morphology and Genetics, UNIFESP, São Paulo, Brazil
| | - Ary Gadelha
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil.,Post-Graduation Program in Psychiatry and Medical Psychology, UNIFESP, São Paulo, Brazil
| | - Marcos L Santoro
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil.,Post-Graduation Program in Psychiatry and Medical Psychology, UNIFESP, São Paulo, Brazil.,Genetics Division, Department of Morphology and Genetics, UNIFESP, São Paulo, Brazil
| | - Giovanni A Salum
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil
| | - Luis Augusto Rohde
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil
| | - Arthur Caye
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil
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19
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Cerqueira RO, Ziebold C, Cavalcante D, Oliveira G, Vásquez J, Undurraga J, González-Valderrama A, Nachar R, Lopez-Jaramillo C, Noto C, Crossley N, Gadelha A. Differences of affective and non-affective psychoses in early intervention services from Latin America. J Affect Disord 2022; 316:83-90. [PMID: 35961602 DOI: 10.1016/j.jad.2022.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 06/29/2022] [Accepted: 08/06/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Psychosis presentation can be affected by genetic and environmental factors. Differentiating between affective and non-affective psychosis (A-FEP and NA-FEP, respectively) may influence treatment decisions and clinical outcomes. The objective of this paper is to examine differences between patients with A-FEP or NA-FEP in a Latin American sample. METHODS Patients from two cohorts of patients with a FEP recruited from Brazil and Chile. Subjects included were aged between 15 and 30 years, with an A-FEP or NA-FEP (schizophrenia-spectrum disorders) according to DSM-IV-TR. Sociodemographic data, duration of untreated psychosis and psychotic/mood symptoms were assessed. Generalized estimating equation models were used to assess clinical changes between baseline-follow-up according to diagnosis status. RESULTS A total of 265 subjects were included. Most of the subjects were male (70.9 %), mean age was 21.36 years. A-FEP and NA-FEP groups were similar in almost all sociodemographic variables, but A-FEP patients had a higher probability of being female. At baseline, the A-FEP group had more manic symptoms and a steeper reduction in manic symptoms scores during the follow- up. The NA-FEP group had more negative symptoms at baseline and a higher improvement during follow-up. All domains of The Positive and Negative Syndrome Scale improved for both groups. No difference for DUP and depression z-scores at baseline and follow-up. LIMITATIONS The sample was recruited at tertiary hospitals, which may bias the sample towards more severe cases. CONCLUSIONS This is the largest cohort comparing A-FEP and NA-FEP in Latin America. We found that features in FEP patients could be used to improve diagnosis and support treatment decisions.
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Affiliation(s)
- Raphael O Cerqueira
- Laboratory of Integrative Neuroscience (LiNC), Federal University of Sao Paulo (UNIFESP), Brazil
| | - Carolina Ziebold
- Laboratory of Integrative Neuroscience (LiNC), Federal University of Sao Paulo (UNIFESP), Brazil
| | - Daniel Cavalcante
- Laboratory of Integrative Neuroscience (LiNC), Federal University of Sao Paulo (UNIFESP), Brazil; Early Psychosis Group (GAPi), Federal University of Sao Paulo (UNIFESP), Brazil
| | - Giovany Oliveira
- Genetics Division, Department of Morphology and Genetics, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Javiera Vásquez
- Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Juan Undurraga
- Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile; Department of Neurology and Psychiatry, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | | | - Ruben Nachar
- Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile
| | | | - Cristiano Noto
- Laboratory of Integrative Neuroscience (LiNC), Federal University of Sao Paulo (UNIFESP), Brazil; Early Psychosis Group (GAPi), Federal University of Sao Paulo (UNIFESP), Brazil
| | - Nicolas Crossley
- Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ary Gadelha
- Laboratory of Integrative Neuroscience (LiNC), Federal University of Sao Paulo (UNIFESP), Brazil; Early Psychosis Group (GAPi), Federal University of Sao Paulo (UNIFESP), Brazil.
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20
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Massuda R, Gama CS, Belmonte-de-Abreu P, Elkis H, de Lucena DF, Bressan R, Noto C, Gadelha A. Clozapine prescription trends in Brazil in the last decade. Braz J Psychiatry 2022; 44:635-638. [PMID: 36327429 PMCID: PMC9851753 DOI: 10.47626/1516-4446-2022-2572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/07/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Clozapine is a second-generation antipsychotic indicated for treatment-resistant schizophrenia. Studies in several countries have shown a low rate of clozapine use despite the fact that approximately 30% of schizophrenia cases are treatment-resistant. In Brazil, few studies have addressed the frequency and variety of antipsychotic use in individuals diagnosed with schizophrenia (ICD F20). The objective of this study was to measure the rates of clozapine use in this population in the last decade using Brazilian Ministry of Health data. METHODS Prescriptions made between 2010 and 2020 in all 26 states and the Federal District registered at the Outpatient Information System Database from the Brazilian Health System (SIASUS) were evaluated. RESULTS A total of 25,143,524 prescriptions were recorded in this period, with clozapine representing 8.86% of all antipsychotics. The most frequently prescribed antipsychotic for patients with schizophrenia was olanzapine (35.8%), followed by quetiapine (27.5%). From 2010 to 2020, the rate of clozapine prescriptions in Brazil increased from 7.2% to 10.9%. CONCLUSIONS Despite a slight increase in prescriptions in the last decade, clozapine is still underutilized in Brazil.
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Affiliation(s)
- Raffael Massuda
- Departamento de Psiquiatria, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil,Correspondence: Raffael Massuda, Departamento de Psiquiatria, Universidade Federal do Paraná (UFPR), Rua Padre Camargo, 280, CEP 80060-240, Curitiba, PR, Brazil. E-mail:
| | - Clarissa S. Gama
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Paulo Belmonte-de-Abreu
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Helio Elkis
- Departamento de Psiquiatria, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
| | - David Freitas de Lucena
- Departamento de Farmacologia Clínica, Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil
| | - Rodrigo Bressan
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Cristiano Noto
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Ary Gadelha
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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21
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Koga G, Haguiara B, Ortiz B, Noto C, Freitas RR, Elkis H, Bressan R, Ziebold C, Gadelha A. Negative dimension stability across clinical stages and sociodemographic characteristics in schizophrenia. Braz J Psychiatry 2022; 44:558-560. [PMID: 36423329 PMCID: PMC9561841 DOI: 10.47626/1516-4446-2022-2570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 04/30/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Gabriela Koga
- Laboratório Interdisciplinar de Neurociências Clínicas, Departamento de Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo (USP), SP, Brazil
| | - Bernardo Haguiara
- Laboratório Interdisciplinar de Neurociências Clínicas, Departamento de Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo (USP), SP, Brazil
| | - Bruno Ortiz
- Laboratório Interdisciplinar de Neurociências Clínicas, Departamento de Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo (USP), SP, Brazil,Programa de Esquizofrenia da Escola Paulista de Medicina, UNIFESP, SP, Brazil
| | - Cristiano Noto
- Laboratório Interdisciplinar de Neurociências Clínicas, Departamento de Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo (USP), SP, Brazil,Programa de Esquizofrenia da Escola Paulista de Medicina, UNIFESP, SP, Brazil
| | | | - Helio Elkis
- Programa de Esquizofrenia do Instituto de Psiquiatria, USP, SP, Brazil
| | - Rodrigo Bressan
- Laboratório Interdisciplinar de Neurociências Clínicas, Departamento de Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo (USP), SP, Brazil,Programa de Esquizofrenia da Escola Paulista de Medicina, UNIFESP, SP, Brazil,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK,Instituto Ame Sua Mente, São Paulo, SP, Brazil
| | - Carolina Ziebold
- Laboratório Interdisciplinar de Neurociências Clínicas, Departamento de Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo (USP), SP, Brazil
| | - Ary Gadelha
- Laboratório Interdisciplinar de Neurociências Clínicas, Departamento de Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo (USP), SP, Brazil,Programa de Esquizofrenia da Escola Paulista de Medicina, UNIFESP, SP, Brazil
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22
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Czepielewski LS, Alliende LM, Castañeda CP, Castro M, Guinjoan SM, Massuda R, Berberian AA, Fonseca AO, Gadelha A, Bressan R, Crivelaro M, Louzã M, Undurraga J, González-Valderrama A, Nachar R, Nieto RR, Montes C, Silva H, Langer ÁI, Schmidt C, Mayol-Troncoso R, Díaz-Zuluaga AM, Valencia-Echeverry J, López-Jaramillo C, Solís-Vivanco R, Reyes-Madrigal F, de la Fuente-Sandoval C, Crossley NA, Gama CS. Effects of socioeconomic status in cognition of people with schizophrenia: results from a Latin American collaboration network with 1175 subjects. Psychol Med 2022; 52:2177-2188. [PMID: 34158132 DOI: 10.1017/s0033291721002403] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Cognition heavily relies on social determinants and genetic background. Latin America comprises approximately 8% of the global population and faces unique challenges, many derived from specific demographic and socioeconomic variables, such as violence and inequality. While such factors have been described to influence mental health outcomes, no large-scale studies with Latin American population have been carried out. Therefore, we aim to describe the cognitive performance of a representative sample of Latin American individuals with schizophrenia and its relationship to clinical factors. Additionally, we aim to investigate how socioeconomic status (SES) relates to cognitive performance in patients and controls. METHODS We included 1175 participants from five Latin American countries (Argentina, Brazil, Chile, Colombia, and Mexico): 864 individuals with schizophrenia and 311 unaffected subjects. All participants were part of projects that included cognitive evaluation with MATRICS Consensus Cognitive Battery and clinical assessments. RESULTS Patients showed worse cognitive performance than controls across all domains. Age and diagnosis were independent predictors, indicating similar trajectories of cognitive aging for both patients and controls. The SES factors of education, parental education, and income were more related to cognition in patients than in controls. Cognition was also influenced by symptomatology. CONCLUSIONS Patients did not show evidence of accelerated cognitive aging; however, they were most impacted by a lower SES suggestive of deprived environment than controls. These findings highlight the vulnerability of cognitive capacity in individuals with psychosis in face of demographic and socioeconomic factors in low- and middle-income countries.
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Affiliation(s)
- Letícia Sanguinetti Czepielewski
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Programa de Pós-Graduação em Psicologia, Instituto de Psicologia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Luz Maria Alliende
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile
| | - Carmen Paz Castañeda
- Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile
| | - Mariana Castro
- Research Group on Neurosciences as applied to Abnormal Behaviour (INAAC Group), FLENI-CONICET Neurosciences Institute, Buenos Aires, Argentina
- Department of Psychiatry and Mental Health (Fleni Teaching Unit) and Department of Physiology, University of Buenos Aires School of Medicine, Buenos Aires, Argentina
| | - Salvador M Guinjoan
- Department of Psychiatry and Mental Health (Fleni Teaching Unit), University of Buenos Aires School of Medicine. CONICET, Buenos Aires, Argentina
| | - Raffael Massuda
- Departamento de Psiquiatria, Universidade Federal do Paraná (UFPR), Curitiba, Brazil
| | | | | | - Ary Gadelha
- Programa de Esquizofrenia, da Escola Paulista de Medicina Universidade Federal de São Paulo (PROESQ-EPM/UNIFESP). Laboratory of Integrative Neuroscience (LINC), Escola Paulista de Medicina Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Marisa Crivelaro
- PROJESQ (Programa de Esquizofrenia), Instituto de Psiquiatria do HCFMUSP, São Paulo, Brazil
| | - Mario Louzã
- PROJESQ (Programa de Esquizofrenia), Instituto de Psiquiatria do HCFMUSP, São Paulo, Brazil
| | - Juan Undurraga
- Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile
- Department of Neurology and Psychiatry, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Alfonso González-Valderrama
- Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile
- School of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Rubén Nachar
- Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile
- School of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Rodrigo R Nieto
- University Psychiatric Clinic, Clinical Hospital, Universidad de Chile, Santiago, Chile
- Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Department of Neuroscience, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Cristian Montes
- University Psychiatric Clinic, Clinical Hospital, Universidad de Chile, Santiago, Chile
- Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Hernan Silva
- University Psychiatric Clinic, Clinical Hospital, Universidad de Chile, Santiago, Chile
- Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Álvaro I Langer
- Instituto de Estudios Psicológicos, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
- Center for Interdisciplinary Studies on the Nervous System (CISNe), Universidad Austral de Chile, Valdivia, Chile
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
| | - Carlos Schmidt
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
- Brain, Cognition and Behavior PhD Program, University of Barcelona, Barcelona, Spain
| | - Rocío Mayol-Troncoso
- University Psychiatric Clinic, Clinical Hospital, Universidad de Chile, Santiago, Chile
- Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile
| | - Ana M Díaz-Zuluaga
- Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Johanna Valencia-Echeverry
- Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Carlos López-Jaramillo
- Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Rodolfo Solís-Vivanco
- Laboratory of Neuropsychology, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Francisco Reyes-Madrigal
- Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Camilo de la Fuente-Sandoval
- Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
- Neuropsychiatry Department, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Nicolás A Crossley
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Biomedical Imaging Center and Center for Integrative Neuroscience, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - Clarissa S Gama
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Czepielewski LS, Alliende LM, Castañeda CP, Castro M, Guinjoan SM, Massuda R, Berberian AA, Fonseca AO, Gadelha A, Bressan R, Crivelaro M, Louzã M, Undurraga J, González-Valderrama A, Nachar R, Nieto RR, Montes C, Silva H, Langer ÁI, Schmidt C, Mayol-Troncoso R, Díaz-Zuluaga AM, Valencia-Echeverry J, López-Jaramillo C, Solís-Vivanco R, Reyes-Madrigal F, de la Fuente-Sandoval C, Crossley NA, Gama CS. Effects of Socioeconomic Status in Cognition of People with Schizophrenia: Results From a Latin American Collaboration Network with 1175 Subjects - CORRIGENDUM. Psychol Med 2022; 52:2198. [PMID: 35527709 DOI: 10.1017/s0033291721003949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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24
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Crossley NA, Alliende LM, Czepielewski LS, Aceituno D, Castañeda CP, Diaz C, Iruretagoyena B, Mena C, Mena C, Ramirez-Mahaluf JP, Tepper A, Vasquez J, Fonseca L, Machado V, Hernández CE, Vargas-Upegui C, Gomez-Cruz G, Kobayashi-Romero LF, Moncada-Habib T, Arango C, Barch DM, Carter C, Correll CU, Freimer NB, McGuire P, Evans-Lacko S, Undurraga E, Bressan R, Gama CS, Lopez-Jaramillo C, de la Fuente-Sandoval C, Gonzalez-Valderrama A, Undurraga J, Gadelha A. The enduring gap in educational attainment in schizophrenia according to the past 50 years of published research: a systematic review and meta-analysis. Lancet Psychiatry 2022; 9:565-573. [PMID: 35717966 DOI: 10.1016/s2215-0366(22)00121-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Educational attainment is associated with wellbeing and health, but patients with schizophrenia achieve lower levels of education than people without. Several effective interventions can ameliorate this situation. However, the magnitude of the education gap in schizophrenia and its change over time are unclear. We aimed to reconstruct the trajectories of educational attainment in patients with schizophrenia and, if reported, their healthy comparator controls. METHODS We did a systematic review and meta-analysis including all studies reporting on patients with schizophrenia (of mean age ≥18 years) and describing the number of years of education of the participants, with or without healthy controls. There were no other design constraints on studies. We excluded studies that included only patients with other schizophrenia spectrum disorders and studies that did not specify the number of years of education of the participants. 22 reviewers participated in retrieving data from a search in PubMed and PsycINFO (Jan 1, 1970, to Nov 24, 2020). We estimated the birth date of participants from their mean age and publication date, and meta-analysed these data using random-effects models, focusing on educational attainment, the education gap, and changes over time. The primary outcome was years of education. The protocol was registered on PROSPERO (CRD42020220546). FINDINGS From 32 593 initial references, we included 3321 studies reporting on 318 632 patients alongside 138 675 healthy controls (170 941 women and 275 821 men from studies describing sex or gender; data on ethnicity were not collected). Patients' educational attainment increased over time, mirroring that of controls. However, patients with schizophrenia in high-income countries had 19 months less education than controls (-1·59 years, 95% CI -1·66 to -1·53; p<0·0001), which is equivalent to a Cohen's d of -0·56 (95% CI -0·58 to -0·54) and implies an odds ratio of 2·58 for not completing 12 years of education (ie, not completing secondary education) for patients compared with controls. This gap remained stable throughout the decades; the rate of change in number of total years of education in time was not significant (annual change: 0·0047 years, 95% CI -0·0005 to 0·0099; p=0·078). For patients in low-income and middle-income countries, the education gap was significantly smaller than in high-income countries (smaller by 0·72 years, 0·85 to 0·59; p<0·0001), yet there was evidence that this gap was widening over the years, approaching that of high-income countries (annual change: -0·024 years, -0·037 to -0·011; p=0·0002). INTERPRETATION Patients with schizophrenia have faced persistent inequality in educational attainment in the last century, despite advances in psychosocial and pharmacological treatment. Reducing this gap should become a priority to improve their functional outcomes. FUNDING Ciencia y Tecnología para el Desarrollo (CYTED) to the Latin American Network for the Study of Early Psychosis (ANDES).
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Affiliation(s)
- Nicolás A Crossley
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Luz María Alliende
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Department of Psychiatry and Behavioral Neuroscience, School of Medicine, The University of Chicago, Chicago, IL, USA
| | - Leticia S Czepielewski
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Programa de Pós-Graduação em Psicologia, Instituto Psicologia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - David Aceituno
- Psychiatry and Mental Health Service, Complejo Asistencial Dr Sótero del Río, Puente Alto, Chile
| | - Carmen Paz Castañeda
- Early Intervention Program, Instituto Psiquiátrico Dr. J. Horwitz Barak, Santiago, Chile
| | - Camila Diaz
- Pharmacovigilance Program, Instituto Psiquiátrico Dr. J. Horwitz Barak, Santiago, Chile
| | - Barbara Iruretagoyena
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Department of Neurology and Psychiatry, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Vitacura, Chile
| | - Carlos Mena
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Institute of Cognitive Neuroscience, University College London, London, UK
| | - Cristian Mena
- Early Intervention Program, Instituto Psiquiátrico Dr. J. Horwitz Barak, Santiago, Chile; School of Medicine, Universidad Finis Terrae, Santiago, Chile
| | | | - Angeles Tepper
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Javiera Vasquez
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Lais Fonseca
- Schizophrenia Program (PROESQ), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Viviane Machado
- Schizophrenia Program (PROESQ), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Camilo E Hernández
- Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia
| | - Cristian Vargas-Upegui
- Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia
| | - Gladys Gomez-Cruz
- Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Luis F Kobayashi-Romero
- Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Tomas Moncada-Habib
- Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, CIBERSAM, Madrid, Spain
| | - Deanna M Barch
- School of Medicine, University of Washington in St Louis, St Louis, MO, USA
| | - Cameron Carter
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Davis, CA, USA
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Nelson B Freimer
- Center for Neurobehavioral Genetics, Jane and Terry Semel Institute for Neuroscience and Human Los Angeles, CA, USA
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sara Evans-Lacko
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Eduardo Undurraga
- School of Government, Pontificia Universidad Católica de Chile, Santiago, Chile; Research Center for Integrated Disaster Risk Management (CIGIDEN), Santiago, Chile; CIFAR Azrieli Global Scholars Program, CIFAR, Toronto, ON, Canada
| | - Rodrigo Bressan
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Clarissa S Gama
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Carlos Lopez-Jaramillo
- Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia
| | | | - Alfonso Gonzalez-Valderrama
- Early Intervention Program, Instituto Psiquiátrico Dr. J. Horwitz Barak, Santiago, Chile; School of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Juan Undurraga
- Early Intervention Program, Instituto Psiquiátrico Dr. J. Horwitz Barak, Santiago, Chile; Department of Neurology and Psychiatry, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Vitacura, Chile
| | - Ary Gadelha
- Schizophrenia Program (PROESQ), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
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25
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Ortiz BB, Gadelha A, Bressan RA. Should we rethink how we introduce schizophrenia? Schizophr Res 2022; 244:134. [PMID: 35661551 DOI: 10.1016/j.schres.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/11/2022] [Accepted: 05/13/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Bruno Bertolucci Ortiz
- Group of Resistant Schizophrenia (GER), Federal University of São Paulo (Unifesp), SP, Brazil; Schizophrenia Program (Proesq), Unifesp, SP, Brazil; Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), Unifesp, SP, Brazil.
| | - Ary Gadelha
- Group of Resistant Schizophrenia (GER), Federal University of São Paulo (Unifesp), SP, Brazil; Schizophrenia Program (Proesq), Unifesp, SP, Brazil; Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), Unifesp, SP, Brazil
| | - Rodrigo Affonseca Bressan
- Group of Resistant Schizophrenia (GER), Federal University of São Paulo (Unifesp), SP, Brazil; Schizophrenia Program (Proesq), Unifesp, SP, Brazil; Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), Unifesp, SP, Brazil
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26
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Rebello K, Moura LM, Bueno APA, Picon FA, Pan PM, Gadelha A, Miguel EC, Bressan RA, Rohde LA, Sato JR. Associations between Family Functioning and Maternal Behavior on Default Mode Network Connectivity in School-Age Children. Int J Environ Res Public Health 2022; 19:ijerph19106055. [PMID: 35627592 PMCID: PMC9141331 DOI: 10.3390/ijerph19106055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/16/2022] [Accepted: 05/03/2022] [Indexed: 02/04/2023]
Abstract
Background: Most early children's experiences will occur in a family context; therefore, the quality of this environment is critical for development outcomes. Not many studies have assessed the correlations between brain functional connectivity (FC) in important areas such as the default mode network (DMN) and the quality of parent-child relationships in school-age children and early adolescence. The quality of family relationships and maternal behavior have been suggested to modulate DMN FC once they act as external regulators of children's affect and behavior. Objective: We aimed to test the associations between the quality of family environment/maternal behavior and FC within the DMN of school-age children. Method: Resting-state, functional magnetic resonance imaging data, were collected from 615 children (6-12 age range) enrolled in the Brazilian High-Risk Cohort (HRC) study. We assessed DMN intra-connectivity between the medial prefrontal cortex (mPFC), posterior cingulate cortex (PCC), and inferior parietal lobule (IPL-bilateral) regions. The family functioning was assessed by levels of family cohesiveness and conflict and by maternal behavior styles such as maternal responsiveness, maternal stimulus to the child's autonomy, and maternal overprotection. The family environment was assessed with the Family Environment Scale (FES), and maternal behavior was assessed by the mother's self-report. Results: We found that the quality of the family environment was correlated with intra-DMN FC. The more conflicting the family environment was, the greater the FC between the mPFC-left IPL (lIPL), while a more cohesive family functioning was negatively correlated with FC between the PCC-lIPL. On the other hand, when moderated by a positive maternal behavior, cohesive family functioning was associated with increased FC in both regions of the DMN (mPFC-lIPL and PCC-lIPL). Conclusions: Our results highlight that the quality of the family environment might be associated with differences in the intrinsic DMN FC.
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Affiliation(s)
- Keila Rebello
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Santo André 09210-580, Brazil; (K.R.); (L.M.M.); (A.P.A.B.)
| | - Luciana Monteiro Moura
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Santo André 09210-580, Brazil; (K.R.); (L.M.M.); (A.P.A.B.)
- Interdisciplinary Lab for Clinical Neurosciences, Universidade Federal de São Paulo, São Paulo 04021-001, Brazil; (P.M.P.); (A.G.); (R.A.B.)
- National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo 01060-970, Brazil; (F.A.P.); (E.C.M.); (L.A.R.)
| | - Ana Paula Arantes Bueno
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Santo André 09210-580, Brazil; (K.R.); (L.M.M.); (A.P.A.B.)
| | - Felipe Almeida Picon
- National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo 01060-970, Brazil; (F.A.P.); (E.C.M.); (L.A.R.)
- ADHD Outpatient Program & Developmental Psychiatry Program, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre 90010-150, Brazil
| | - Pedro Mario Pan
- Interdisciplinary Lab for Clinical Neurosciences, Universidade Federal de São Paulo, São Paulo 04021-001, Brazil; (P.M.P.); (A.G.); (R.A.B.)
- National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo 01060-970, Brazil; (F.A.P.); (E.C.M.); (L.A.R.)
| | - Ary Gadelha
- Interdisciplinary Lab for Clinical Neurosciences, Universidade Federal de São Paulo, São Paulo 04021-001, Brazil; (P.M.P.); (A.G.); (R.A.B.)
- National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo 01060-970, Brazil; (F.A.P.); (E.C.M.); (L.A.R.)
| | - Euripedes Constatino Miguel
- National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo 01060-970, Brazil; (F.A.P.); (E.C.M.); (L.A.R.)
- Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo 05508-070, Brazil
| | - Rodrigo Affonseca Bressan
- Interdisciplinary Lab for Clinical Neurosciences, Universidade Federal de São Paulo, São Paulo 04021-001, Brazil; (P.M.P.); (A.G.); (R.A.B.)
- National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo 01060-970, Brazil; (F.A.P.); (E.C.M.); (L.A.R.)
| | - Luis Augusto Rohde
- National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo 01060-970, Brazil; (F.A.P.); (E.C.M.); (L.A.R.)
- ADHD Outpatient Program & Developmental Psychiatry Program, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre 90010-150, Brazil
| | - João Ricardo Sato
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Santo André 09210-580, Brazil; (K.R.); (L.M.M.); (A.P.A.B.)
- Interdisciplinary Lab for Clinical Neurosciences, Universidade Federal de São Paulo, São Paulo 04021-001, Brazil; (P.M.P.); (A.G.); (R.A.B.)
- National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo 01060-970, Brazil; (F.A.P.); (E.C.M.); (L.A.R.)
- ADHD Outpatient Program & Developmental Psychiatry Program, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre 90010-150, Brazil
- Correspondence:
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Higuchi CH, Cogo-Moreira H, Fonseca L, Ortiz BB, Correll CU, Noto C, Cordeiro Q, de Freitas R, Elkis H, Belangero SI, Bressan RA, Gadelha A. Identifying strategies to improve PANSS based dimensional models in schizophrenia: Accounting for multilevel structure, Bayesian model and clinical staging. Schizophr Res 2022; 243:424-430. [PMID: 34304964 DOI: 10.1016/j.schres.2021.06.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 03/10/2021] [Accepted: 06/23/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Dimensional approaches can decompose a construct in a set of continuous variables, improving the characterization of complex phenotypes, such as schizophrenia. However, the five-factor model of the Positive and Negative Syndrome Scale (PANSS), the most used instrument in schizophrenia research, yielded poor fits in most confirmatory factor analysis (CFA) studies, raising concerns about its applications. Thus, we aimed to identify dimensional PANSS CFA models with good psychometric properties by comparing the traditional CFA with three methodological approaches: Bayesian CFA, multilevel modeling, and Multiple Indicators Multiple Causes (MIMIC) modeling. METHODS Clinical data of 700 schizophrenia patients from four centers were analyzed. We first performed a traditional CFA. Next, we tested the three techniques: 1) a Bayesian CFA; 2) a multilevel analysis using the centers as level; and 3) a MIMIC modeling to evaluate the impact of clinical staging on PANSS factors and items. RESULTS CFA and Bayesian CFA produced poor fit models. However, when adding a multilevel structure to the CFA model, a good fit model emerged. MIMIC modeling yielded significant differences in the factor structure between the clinical stages of schizophrenia. Sex, age, age of onset, and duration of illness did not significantly affect the model fit. CONCLUSION Our comparison of different CFA methods highlights the need for multilevel structure to achieve a good fit model and the potential utility of staging models (rather than the duration of illness) to deal with clinical heterogeneity in schizophrenia. Large prospective samples with biological data should help to understand the interplay between psychometrics concerns and neurobiology research.
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Affiliation(s)
- Cinthia H Higuchi
- Laboratory of Integrative Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, SP, Brazil; Programa de Esquizofrenia da Universidade Federal de São Paulo (PROESQ), SP, Brazil
| | | | - Lais Fonseca
- Laboratory of Integrative Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, SP, Brazil; Programa de Esquizofrenia da Universidade Federal de São Paulo (PROESQ), SP, Brazil
| | - Bruno B Ortiz
- Laboratory of Integrative Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, SP, Brazil; Programa de Esquizofrenia da Universidade Federal de São Paulo (PROESQ), SP, Brazil
| | - Christoph U Correll
- The Zucker Hillside Hospital, Psychiatry Research, Glen Oaks, NY, USA; Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA; Charité Universitätsmedizin, Department of Child and Adolescent Psychiatry, Berlin, Germany
| | - Cristiano Noto
- Laboratory of Integrative Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, SP, Brazil; Programa de Esquizofrenia da Universidade Federal de São Paulo (PROESQ), SP, Brazil
| | - Quirino Cordeiro
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, SP, Brazil
| | - Rosana de Freitas
- Schizophrenia Research Program (PROJESQ), Department and Institute of Psychiatry, Universidade de São Paulo (USP), SP, Brazil
| | - Helio Elkis
- Schizophrenia Research Program (PROJESQ), Department and Institute of Psychiatry, Universidade de São Paulo (USP), SP, Brazil
| | - Sintia I Belangero
- Laboratory of Integrative Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, SP, Brazil; Department of Morphology and Genetics, Universidade Federal de São Paulo, SP, Brazil
| | - Rodrigo A Bressan
- Laboratory of Integrative Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, SP, Brazil; Programa de Esquizofrenia da Universidade Federal de São Paulo (PROESQ), SP, Brazil; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Ary Gadelha
- Laboratory of Integrative Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, SP, Brazil; Programa de Esquizofrenia da Universidade Federal de São Paulo (PROESQ), SP, Brazil.
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Kagan S, Cogo-Moreira H, Barbosa MG, Cavalcante D, Shinji A, Noto M, Haguiara B, Cordeiro Q, Belangeiro S, Bressan RA, Noto C, Gadelha A. Longitudinal invariance of the positive and negative syndrome scale negative dimension in antipsychotic naïve first-episode schizophrenia. Early Interv Psychiatry 2022; 16:581-586. [PMID: 34265870 DOI: 10.1111/eip.13200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 04/29/2021] [Accepted: 07/04/2021] [Indexed: 11/29/2022]
Abstract
AIM Construct stability over time is required for reliable inference, but evidence regarding the longitudinal invariance of negative symptoms is still limited. Thus, we examined the longitudinal invariance of the negative dimension using the positive and negative syndrome scale (PANSS) in an antipsychotic-naïve first-episode schizophrenia sample at baseline and after 10 weeks. METHODS Our study was conducted at a specialized early intervention service. PANSS ratings were analysed for 138 patients, and two different models were specified and tested: a unidimensional and a two-correlated factor solution. RESULTS The unidimensional model fulfilled criteria for longitudinal invariance, whilst the two-correlated did not. CONCLUSION Our study provides support for the PANSS negative unidimensional model use to evaluate negative symptoms' longitudinal change following first-episode schizophrenia.
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Affiliation(s)
- Simão Kagan
- Laboratory of Integrative Neurosciences (LiNC), Department of Psychiatry, Federal University of Sao Paulo (EPM/UNIFESP), Sao Paulo, Brazil.,Schizophrenia Program (PROESQ), Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Hugo Cogo-Moreira
- Laboratory of Integrative Neurosciences (LiNC), Department of Psychiatry, Federal University of Sao Paulo (EPM/UNIFESP), Sao Paulo, Brazil
| | - Matheus Ghossain Barbosa
- Laboratory of Integrative Neurosciences (LiNC), Department of Psychiatry, Federal University of Sao Paulo (EPM/UNIFESP), Sao Paulo, Brazil
| | - Daniel Cavalcante
- Laboratory of Integrative Neurosciences (LiNC), Department of Psychiatry, Federal University of Sao Paulo (EPM/UNIFESP), Sao Paulo, Brazil.,Early Psychosis Group (GAPI), Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - André Shinji
- Laboratory of Integrative Neurosciences (LiNC), Department of Psychiatry, Federal University of Sao Paulo (EPM/UNIFESP), Sao Paulo, Brazil.,Early Psychosis Group (GAPI), Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Mariane Noto
- Early Psychosis Group (GAPI), Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Bernardo Haguiara
- Laboratory of Integrative Neurosciences (LiNC), Department of Psychiatry, Federal University of Sao Paulo (EPM/UNIFESP), Sao Paulo, Brazil.,Schizophrenia Program (PROESQ), Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Quirino Cordeiro
- Laboratory of Integrative Neurosciences (LiNC), Department of Psychiatry, Federal University of Sao Paulo (EPM/UNIFESP), Sao Paulo, Brazil
| | - Sintia Belangeiro
- Laboratory of Integrative Neurosciences (LiNC), Department of Psychiatry, Federal University of Sao Paulo (EPM/UNIFESP), Sao Paulo, Brazil.,Department of Morphology and Genetics, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Rodrigo A Bressan
- Laboratory of Integrative Neurosciences (LiNC), Department of Psychiatry, Federal University of Sao Paulo (EPM/UNIFESP), Sao Paulo, Brazil.,Schizophrenia Program (PROESQ), Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil.,Center for Research and Innovation in Prevention of Mental Disorders and Drug Use (CEPIPREV), Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Cristiano Noto
- Laboratory of Integrative Neurosciences (LiNC), Department of Psychiatry, Federal University of Sao Paulo (EPM/UNIFESP), Sao Paulo, Brazil.,Schizophrenia Program (PROESQ), Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil.,Early Psychosis Group (GAPI), Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil.,Center for Research and Innovation in Prevention of Mental Disorders and Drug Use (CEPIPREV), Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Ary Gadelha
- Laboratory of Integrative Neurosciences (LiNC), Department of Psychiatry, Federal University of Sao Paulo (EPM/UNIFESP), Sao Paulo, Brazil.,Schizophrenia Program (PROESQ), Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil.,Early Psychosis Group (GAPI), Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil.,Center for Research and Innovation in Prevention of Mental Disorders and Drug Use (CEPIPREV), Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
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Trubetskoy V, Pardiñas AF, Qi T, Panagiotaropoulou G, Awasthi S, Bigdeli TB, Bryois J, Chen CY, Dennison CA, Hall LS, Lam M, Watanabe K, Frei O, Ge T, Harwood JC, Koopmans F, Magnusson S, Richards AL, Sidorenko J, Wu Y, Zeng J, Grove J, Kim M, Li Z, Voloudakis G, Zhang W, Adams M, Agartz I, Atkinson EG, Agerbo E, Al Eissa M, Albus M, Alexander M, Alizadeh BZ, Alptekin K, Als TD, Amin F, Arolt V, Arrojo M, Athanasiu L, Azevedo MH, Bacanu SA, Bass NJ, Begemann M, Belliveau RA, Bene J, Benyamin B, Bergen SE, Blasi G, Bobes J, Bonassi S, Braun A, Bressan RA, Bromet EJ, Bruggeman R, Buckley PF, Buckner RL, Bybjerg-Grauholm J, Cahn W, Cairns MJ, Calkins ME, Carr VJ, Castle D, Catts SV, Chambert KD, Chan RCK, Chaumette B, Cheng W, Cheung EFC, Chong SA, Cohen D, Consoli A, Cordeiro Q, Costas J, Curtis C, Davidson M, Davis KL, de Haan L, Degenhardt F, DeLisi LE, Demontis D, Dickerson F, Dikeos D, Dinan T, Djurovic S, Duan J, Ducci G, Dudbridge F, Eriksson JG, Fañanás L, Faraone SV, Fiorentino A, Forstner A, Frank J, Freimer NB, Fromer M, Frustaci A, Gadelha A, Genovese G, Gershon ES, Giannitelli M, Giegling I, Giusti-Rodríguez P, Godard S, Goldstein JI, González Peñas J, González-Pinto A, Gopal S, Gratten J, Green MF, Greenwood TA, Guillin O, Gülöksüz S, Gur RE, Gur RC, Gutiérrez B, Hahn E, Hakonarson H, Haroutunian V, Hartmann AM, Harvey C, Hayward C, Henskens FA, Herms S, Hoffmann P, Howrigan DP, Ikeda M, Iyegbe C, Joa I, Julià A, Kähler AK, Kam-Thong T, Kamatani Y, Karachanak-Yankova S, Kebir O, Keller MC, Kelly BJ, Khrunin A, Kim SW, Klovins J, Kondratiev N, Konte B, Kraft J, Kubo M, Kučinskas V, Kučinskiene ZA, Kusumawardhani A, Kuzelova-Ptackova H, Landi S, Lazzeroni LC, Lee PH, Legge SE, Lehrer DS, Lencer R, Lerer B, Li M, Lieberman J, Light GA, Limborska S, Liu CM, Lönnqvist J, Loughland CM, Lubinski J, Luykx JJ, Lynham A, Macek M, Mackinnon A, Magnusson PKE, Maher BS, Maier W, Malaspina D, Mallet J, Marder SR, Marsal S, Martin AR, Martorell L, Mattheisen M, McCarley RW, McDonald C, McGrath JJ, Medeiros H, Meier S, Melegh B, Melle I, Mesholam-Gately RI, Metspalu A, Michie PT, Milani L, Milanova V, Mitjans M, Molden E, Molina E, Molto MD, Mondelli V, Moreno C, Morley CP, Muntané G, Murphy KC, Myin-Germeys I, Nenadić I, Nestadt G, Nikitina-Zake L, Noto C, Nuechterlein KH, O'Brien NL, O'Neill FA, Oh SY, Olincy A, Ota VK, Pantelis C, Papadimitriou GN, Parellada M, Paunio T, Pellegrino R, Periyasamy S, Perkins DO, Pfuhlmann B, Pietiläinen O, Pimm J, Porteous D, Powell J, Quattrone D, Quested D, Radant AD, Rampino A, Rapaport MH, Rautanen A, Reichenberg A, Roe C, Roffman JL, Roth J, Rothermundt M, Rutten BPF, Saker-Delye S, Salomaa V, Sanjuan J, Santoro ML, Savitz A, Schall U, Scott RJ, Seidman LJ, Sharp SI, Shi J, Siever LJ, Sigurdsson E, Sim K, Skarabis N, Slominsky P, So HC, Sobell JL, Söderman E, Stain HJ, Steen NE, Steixner-Kumar AA, Stögmann E, Stone WS, Straub RE, Streit F, Strengman E, Stroup TS, Subramaniam M, Sugar CA, Suvisaari J, Svrakic DM, Swerdlow NR, Szatkiewicz JP, Ta TMT, Takahashi A, Terao C, Thibaut F, Toncheva D, Tooney PA, Torretta S, Tosato S, Tura GB, Turetsky BI, Üçok A, Vaaler A, van Amelsvoort T, van Winkel R, Veijola J, Waddington J, Walter H, Waterreus A, Webb BT, Weiser M, Williams NM, Witt SH, Wormley BK, Wu JQ, Xu Z, Yolken R, Zai CC, Zhou W, Zhu F, Zimprich F, Atbaşoğlu EC, Ayub M, Benner C, Bertolino A, Black DW, Bray NJ, Breen G, Buccola NG, Byerley WF, Chen WJ, Cloninger CR, Crespo-Facorro B, Donohoe G, Freedman R, Galletly C, Gandal MJ, Gennarelli M, Hougaard DM, Hwu HG, Jablensky AV, McCarroll SA, Moran JL, Mors O, Mortensen PB, Müller-Myhsok B, Neil AL, Nordentoft M, Pato MT, Petryshen TL, Pirinen M, Pulver AE, Schulze TG, Silverman JM, Smoller JW, Stahl EA, Tsuang DW, Vilella E, Wang SH, Xu S, Adolfsson R, Arango C, Baune BT, Belangero SI, Børglum AD, Braff D, Bramon E, Buxbaum JD, Campion D, Cervilla JA, Cichon S, Collier DA, Corvin A, Curtis D, Forti MD, Domenici E, Ehrenreich H, Escott-Price V, Esko T, Fanous AH, Gareeva A, Gawlik M, Gejman PV, Gill M, Glatt SJ, Golimbet V, Hong KS, Hultman CM, Hyman SE, Iwata N, Jönsson EG, Kahn RS, Kennedy JL, Khusnutdinova E, Kirov G, Knowles JA, Krebs MO, Laurent-Levinson C, Lee J, Lencz T, Levinson DF, Li QS, Liu J, Malhotra AK, Malhotra D, McIntosh A, McQuillin A, Menezes PR, Morgan VA, Morris DW, Mowry BJ, Murray RM, Nimgaonkar V, Nöthen MM, Ophoff RA, Paciga SA, Palotie A, Pato CN, Qin S, Rietschel M, Riley BP, Rivera M, Rujescu D, Saka MC, Sanders AR, Schwab SG, Serretti A, Sham PC, Shi Y, St Clair D, Stefánsson H, Stefansson K, Tsuang MT, van Os J, Vawter MP, Weinberger DR, Werge T, Wildenauer DB, Yu X, Yue W, Holmans PA, Pocklington AJ, Roussos P, Vassos E, Verhage M, Visscher PM, Yang J, Posthuma D, Andreassen OA, Kendler KS, Owen MJ, Wray NR, Daly MJ, Huang H, Neale BM, Sullivan PF, Ripke S, Walters JTR, O'Donovan MC. Mapping genomic loci implicates genes and synaptic biology in schizophrenia. Nature 2022; 604:502-508. [PMID: 35396580 PMCID: PMC9392466 DOI: 10.1038/s41586-022-04434-5] [Citation(s) in RCA: 741] [Impact Index Per Article: 370.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 01/10/2022] [Indexed: 01/16/2023]
Abstract
Schizophrenia has a heritability of 60-80%1, much of which is attributable to common risk alleles. Here, in a two-stage genome-wide association study of up to 76,755 individuals with schizophrenia and 243,649 control individuals, we report common variant associations at 287 distinct genomic loci. Associations were concentrated in genes that are expressed in excitatory and inhibitory neurons of the central nervous system, but not in other tissues or cell types. Using fine-mapping and functional genomic data, we identify 120 genes (106 protein-coding) that are likely to underpin associations at some of these loci, including 16 genes with credible causal non-synonymous or untranslated region variation. We also implicate fundamental processes related to neuronal function, including synaptic organization, differentiation and transmission. Fine-mapped candidates were enriched for genes associated with rare disruptive coding variants in people with schizophrenia, including the glutamate receptor subunit GRIN2A and transcription factor SP4, and were also enriched for genes implicated by such variants in neurodevelopmental disorders. We identify biological processes relevant to schizophrenia pathophysiology; show convergence of common and rare variant associations in schizophrenia and neurodevelopmental disorders; and provide a resource of prioritized genes and variants to advance mechanistic studies.
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Affiliation(s)
- Vassily Trubetskoy
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - Antonio F Pardiñas
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Ting Qi
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- School of Life Sciences, Westlake University, Hangzhou, China
| | | | - Swapnil Awasthi
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - Tim B Bigdeli
- Department of Psychiatry and the Behavioral Sciences, SUNY Downstate Medical Center, New York, NY, USA
- Institute for Genomic Health, SUNY Downstate Medical Center, New York, NY, USA
- Department of Psychiatry, Veterans Affairs New York Harbor Healthcare System, New York, NY, USA
| | - Julien Bryois
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Chia-Yen Chen
- Biogen, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Charlotte A Dennison
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Lynsey S Hall
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Max Lam
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Research Division, Institute of Mental Health, Singapore, Republic of Singapore
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
| | - Kyoko Watanabe
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Oleksandr Frei
- NORMENT Centre, Division of Mental Health and Addiction, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Center for Bioinformatics, Department of Informatics, University of Oslo, Oslo, Norway
| | - Tian Ge
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Janet C Harwood
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Frank Koopmans
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Faculty of Science, Amsterdam Neuroscience, Vrije Universiteit, Amsterdam, The Netherlands
| | | | - Alexander L Richards
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Julia Sidorenko
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Yang Wu
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Jian Zeng
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Jakob Grove
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Biomedicine and Centre for Integrative Sequencing (iSEQ), Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Minsoo Kim
- Department of Psychiatry, Semel Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Zhiqiang Li
- Affiliated Hospital of Qingdao University and Biomedical Sciences Institute of Qingdao University (Qingdao Branch of SJTU Bio-X Institutes), Qingdao University, Qingdao, China
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Collaborative Innovation Center for Brain Science, Shanghai Jiao Tong University, Shanghai, China
| | - Georgios Voloudakis
- Department of Psychiatry, Pamela Sklar Division of Psychiatric Genomics, Friedman Brain Institute, Department of Genetics and Genomic Science and Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Wen Zhang
- Department of Psychiatry, Pamela Sklar Division of Psychiatric Genomics, Friedman Brain Institute, Department of Genetics and Genomic Science and Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences and Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mark Adams
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - Ingrid Agartz
- NORMENT Centre, Division of Mental Health and Addiction, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Elizabeth G Atkinson
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Esben Agerbo
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Mariam Al Eissa
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | | | - Madeline Alexander
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Behrooz Z Alizadeh
- University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, University of Groningen, Groningen, The Netherlands
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Köksal Alptekin
- Department of Psychiatry, Dokuz Eylül University School of Medicine, Izmir, Turkey
- Department of Neuroscience, Dokuz Eylül University Graduate School of Health Sciences, Izmir, Turkey
| | - Thomas D Als
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Biomedicine and Centre for Integrative Sequencing (iSEQ), Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Farooq Amin
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Volker Arolt
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Manuel Arrojo
- Servizo de Psiquiatría, Complexo Hospitalario Universitario de Santiago de Compostela, Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Spain
| | - Lavinia Athanasiu
- NORMENT Centre, Division of Mental Health and Addiction, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Maria Helena Azevedo
- Institute of Medical Psychology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Silviu A Bacanu
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Nicholas J Bass
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Martin Begemann
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Richard A Belliveau
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Judit Bene
- Department of Medical Genetics, Medical School, University of Pécs, Pécs, Hungary
| | - Beben Benyamin
- Australian Centre for Precision Health, University of South Australia Cancer Research Institute, University of South Australia, Adelaide, South Australia, Australia
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Sarah E Bergen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Giuseppe Blasi
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Julio Bobes
- Área de Psiquiatría-Universidad de Oviedo, Hospital Universitario Central de Asturias (HUCA), Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Oviedo, Asturias, Spain
| | - Stefano Bonassi
- Unit of Clinical and Molecular Epidemiology, IRCCS San Raffaele Roma and San Raffaele University, Rome, Italy
| | - Alice Braun
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - Rodrigo Affonseca Bressan
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Evelyn J Bromet
- Department of Psychiatry and Behavioural Health, Stony Brook University, Stony Brook, NY, USA
| | - Richard Bruggeman
- University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, University of Groningen, Groningen, The Netherlands
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Peter F Buckley
- Health Science Center, University of Tennessee, Memphis, TN, USA
| | - Randy L Buckner
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Jonas Bybjerg-Grauholm
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Wiepke Cahn
- University Medical Center Utrecht, Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, Utrecht, The Netherlands
- Altrecht, General Menthal Health Care, Utrecht, The Netherlands
| | - Murray J Cairns
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, New South Wales, Australia
| | - Monica E Calkins
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Vaughan J Carr
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Department of Psychiatry, Monash University, Melbourne, Victoria, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - David Castle
- Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
- St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Stanley V Catts
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- School of Medicine, University of Queensland, Herston, Queensland, Australia
| | - Kimberley D Chambert
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Raymond C K Chan
- Institute of Psychology, Chinese Academy of Science, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Boris Chaumette
- INSERM U1266, Institute of Psychiatry and Neuroscience of Paris, Université de Paris, GHU Paris Psychiatrie & Neurosciences, Paris, France
- Department of Psychiatry, McGill University, Montreal, Québec, Canada
| | - Wei Cheng
- Department of Computer Science, University of North Carolina, Chapel Hill, NC, USA
| | | | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Republic of Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore
| | - David Cohen
- Faculté de Médecine Sorbonne Université, Groupe de Recherche Clinique no. 15 - Troubles Psychiatriques et Développement (PSYDEV), Department of Child and Adolescent Psychiatry, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
- Centre de Référence des Maladies Rares à Expression Psychiatrique, Department of Child and Adolescent Psychiatry, AP-HP Sorbonne Université, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
- Institut des Systèmes Intelligents et de Robotique (ISIR), CNRS UMR7222, Faculté des Sciences et Ingénierie, Sorbonne Université, Paris, France
| | - Angèle Consoli
- Faculté de Médecine Sorbonne Université, Groupe de Recherche Clinique no. 15 - Troubles Psychiatriques et Développement (PSYDEV), Department of Child and Adolescent Psychiatry, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
- Centre de Référence des Maladies Rares à Expression Psychiatrique, Department of Child and Adolescent Psychiatry, AP-HP Sorbonne Université, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
| | - Quirino Cordeiro
- Department of Psychiatry, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil
| | - Javier Costas
- Instituto de Investigación Sanitaria (IDIS) de Santiago de Compostela, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Spain
| | - Charles Curtis
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | | | - Kenneth L Davis
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Arkin, Institute for Mental Health, Amsterdam, The Netherlands
| | | | - Lynn E DeLisi
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Cambridge Health Alliance, Cambridge, MA, USA
| | - Ditte Demontis
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Biomedicine and Centre for Integrative Sequencing (iSEQ), Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | | | - Dimitris Dikeos
- First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Timothy Dinan
- Department of Psychiatry and Neurobehavioural Sciences, University College Cork, Cork, Ireland
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Srdjan Djurovic
- NORMENT Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - Jubao Duan
- Center for Psychiatric Genetics, NorthShore University HealthSystem, Evanston, IL, USA
- Department of Psychiatry and Behavioral Neurosciences, The University of Chicago, Chicago, IL, USA
| | | | - Frank Dudbridge
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Lourdes Fañanás
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
| | - Stephen V Faraone
- Departments of Psychiatry and Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Alessia Fiorentino
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Andreas Forstner
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Centre for Human Genetics, University of Marburg, Marburg, Germany
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Nelson B Freimer
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Menachem Fromer
- Division of Psychiatric Genomics, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alessandra Frustaci
- Barnet, Enfield and Haringey Mental Health NHS Trust, St Ann's Hospital, London, UK
| | - Ary Gadelha
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Giulio Genovese
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Elliot S Gershon
- Departments of Psychiatry and Human Genetics, University of Chicago, Chicago, IL, USA
| | - Marianna Giannitelli
- Faculté de Médecine Sorbonne Université, Groupe de Recherche Clinique no. 15 - Troubles Psychiatriques et Développement (PSYDEV), Department of Child and Adolescent Psychiatry, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
- Centre de Référence des Maladies Rares à Expression Psychiatrique, Department of Child and Adolescent Psychiatry, AP-HP Sorbonne Université, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
| | - Ina Giegling
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | | | - Stephanie Godard
- Departments of Psychiatry and Human and Molecular Genetics, INSERM, Institut de Myologie, Hôpital de la Pitiè-Salpêtrière, Paris, France
| | - Jacqueline I Goldstein
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Javier González Peñas
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
- BIOARABA Health Research Institute, OSI Araba, University Hospital, University of the Basque Country, Vitoria, Spain
| | - Srihari Gopal
- Neuroscience Therapeutic Area, Janssen Research and Development, Titusville, NJ, USA
| | - Jacob Gratten
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Tiffany A Greenwood
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Olivier Guillin
- INSERM, Rouen, France
- Centre Hospitalier du Rouvray, Rouen, France
- UFR Santé, Université de Rouen Normandie, Rouen, France
| | - Sinan Gülöksüz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Ruben C Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Blanca Gutiérrez
- Department of Psychiatry, Faculty of Medicine and Biomedical Research Centre (CIBM), University of Granada, Granada, Spain
| | - Eric Hahn
- Department of Psychiatry, Charité - Universitätsmedizin, Berlin, Germany
| | - Hakon Hakonarson
- Children's Hospital of Philadelphia, Leonard Madlyn Abramson Research Center, Philadelphia, PA, USA
| | - Vahram Haroutunian
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research Clinical and Education Center (MIRECC), JJ Peters VA Medical Center, New York, NY, USA
| | - Annette M Hartmann
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Carol Harvey
- Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
- NorthWestern Mental Health, Melbourne, Victoria, Australia
| | - Caroline Hayward
- MRC Human Genetics Unit, University of Edinburgh, Institute of Genetics and Cancer, Western General Hospital, Edinburgh, UK
| | - Frans A Henskens
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Stefan Herms
- Division of Medical Genetics, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Per Hoffmann
- Division of Medical Genetics, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Daniel P Howrigan
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Masashi Ikeda
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake Aichi, Japan
| | - Conrad Iyegbe
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Inge Joa
- Regional Centre for Clinical Research in Psychosis, Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway
| | - Antonio Julià
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Anna K Kähler
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Tony Kam-Thong
- Roche Pharma Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center Basel, F. Hoffman-La Roche, Basel, Switzerland
| | - Yoichiro Kamatani
- Laboratory of Complex Trait Genomics, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Sena Karachanak-Yankova
- Department of Medical Genetics, Medical University, Sofia, Bulgaria
- Department of Genetics, Faculty of Biology, Sofia University "St. Kliment Ohridski", Sofia, Bulgaria
| | - Oussama Kebir
- INSERM U1266, Institute of Psychiatry and Neuroscience of Paris, Université de Paris, GHU Paris Psychiatrie & Neurosciences, Paris, France
| | - Matthew C Keller
- Institute for Behavioural Genetics, University of Colorado Boulder, Boulder, CO, USA
| | - Brian J Kelly
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Andrey Khrunin
- Institute of Molecular Genetics of National Research Centre "Kurchatov Institute", Moscow, Russia
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Janis Klovins
- Latvian Biomedical Research and Study Centre, Riga, Latvia
| | | | - Bettina Konte
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Julia Kraft
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Michiaki Kubo
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | | | | | - Agung Kusumawardhani
- Psychiatry Department, University of Indonesia - Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Hana Kuzelova-Ptackova
- Department of Psychiatry, 1st Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Stefano Landi
- Dipartimento di Biologia, Universita' di Pisa, Pisa, Italy
| | - Laura C Lazzeroni
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University, Stanford, CA, USA
| | - Phil H Lee
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry and Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sophie E Legge
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Douglas S Lehrer
- Department of Psychiatry, Wright State University, Dayton, OH, USA
| | - Rebecca Lencer
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Bernard Lerer
- Department of Psychiatry, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Miaoxin Li
- Zhongshan School of Medicine and Key Laboratory of Tropical Diseases Control (SYSU), Sun Yat-sen University, Guangzhou, China
| | | | - Gregory A Light
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- VISN 22, Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
| | - Svetlana Limborska
- Institute of Molecular Genetics of National Research Centre "Kurchatov Institute", Moscow, Russia
| | - Chih-Min Liu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
| | - Jouko Lönnqvist
- Mental Health Unit, Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry, University of Helsinki, Helsinki, Finland
| | - Carmel M Loughland
- Hunter New England Health and University of Newcastle, Newcastle, New South Wales, Australia
| | - Jan Lubinski
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Jurjen J Luykx
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Second Opinion Outpatient Clinic, GGNet Mental Health, Warnsveld, The Netherlands
| | - Amy Lynham
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Milan Macek
- Department of Biology and Medical Genetics, 2nd Faculty of Medicine and University Hospital Motol, Prague, Czech Republic
| | - Andrew Mackinnon
- Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Brion S Maher
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Wolfgang Maier
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Dolores Malaspina
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jacques Mallet
- Asfalia Biologics, iPEPS-ICM, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
| | - Stephen R Marder
- Semel Institute for Neurosciene, University of California Los Angeles, Los Angeles, CA, USA
| | - Sara Marsal
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Alicia R Martin
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Lourdes Martorell
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Manuel Mattheisen
- Department of Biomedicine and Centre for Integrative Sequencing (iSEQ), Aarhus University, Aarhus, Denmark
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | | | - Colm McDonald
- Centre for Neuroimaging, Cognition and Genomics (NICOG), National University of Ireland Galway, Galway, Ireland
| | - John J McGrath
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Brisbane, Queensland, Australia
| | - Helena Medeiros
- Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- College of Medicine, SUNY Downstate Health Sciences University, New York, NY, USA
| | - Sandra Meier
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Bela Melegh
- Department of Medical Genetics, University of Pécs, School of Medicine, Pécs, Hungary
| | - Ingrid Melle
- NORMENT Centre, Division of Mental Health and Addiction, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Raquelle I Mesholam-Gately
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Andres Metspalu
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Patricia T Michie
- School of Psychology, University of Newcastle, Newcastle, New South Wales, Australia
| | - Lili Milani
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Vihra Milanova
- Psychiatric Clinic, Alexandrovska University Hospital, Sofia, Bulgaria
| | - Marina Mitjans
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Espen Molden
- Department of Pharmacy, University of Oslo, Oslo, Norway
- Center for Psychopharmacology, Diakonhjemmet Hospital, Oslo, Norway
| | - Esther Molina
- Department of Nursing, Faculty of Health Sciences and Biomedical Research Centre (CIBM), University of Granada, Granada, Spain
| | - María Dolores Molto
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
- Department of Genetics, Faculty of Biological Sciences, Universidad de Valencia, Valencia, Spain
- Biomedical Research Institute INCLIVA, Valencia, Spain
| | - Valeria Mondelli
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Carmen Moreno
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Christopher P Morley
- Departments of Public Health and Preventive Medicine, Family Medicine, and Psychiatry and Behavioral Sciences, State University of New York, Upstate Medical University, Syracuse, NY, USA
| | - Gerard Muntané
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
- Institut de Biologia Evolutiva (UPF-CSIC), Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, PRBB, Barcelona, Spain
| | - Kieran C Murphy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Inez Myin-Germeys
- Department for Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Igor Nenadić
- Cognitive Neuropsychiatry Laboratory, Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Marburg, Germany
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Cristiano Noto
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Keith H Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Niamh Louise O'Brien
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - F Anthony O'Neill
- Centre for Public Health, Institute of Clinical Sciences, Queen's University Belfast, Belfast, UK
| | - Sang-Yun Oh
- Department of Statistics and Applied Probability, University of California at Santa Barbara, Santa Barbara, CA, USA
- Computational Research Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Ann Olincy
- Department of Psychiatry, University of Colorado Denver, Aurora, CO, USA
| | - Vanessa Kiyomi Ota
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
- Department of Morphology and Genetics, Laboratorio de Genetica, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Christos Pantelis
- NorthWestern Mental Health, Melbourne, Victoria, Australia
- Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
- Department of Psychiatry, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
| | - George N Papadimitriou
- First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Mara Parellada
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Tiina Paunio
- Department of Public Health Solutions, Genomics and Biomarkers Unit, National Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Renata Pellegrino
- Children's Hospital of Philadelphia, Leonard Madlyn Abramson Research Center, Philadelphia, PA, USA
| | - Sathish Periyasamy
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Queensland, Australia
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Bruno Pfuhlmann
- Clinic of Psychiatry and Psychotherapy, Weißer Hirsch, Dresden, Germany
| | - Olli Pietiläinen
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Jonathan Pimm
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - David Porteous
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, UK
| | - John Powell
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Digby Quested
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Allen D Radant
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- VA Puget Sound Health Care System, Seattle, WA, USA
| | - Antonio Rampino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Mark H Rapaport
- Huntsman Mental Health Institute, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Anna Rautanen
- Roche Pharma Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center Basel, F. Hoffman-La Roche, Basel, Switzerland
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cheryl Roe
- SUNY Upstate Medical University, Syracuse, NY, USA
| | - Joshua L Roffman
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Julian Roth
- Department of Psychiatry, Psychosomatics and Psychotherapy, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | | | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | - Veikko Salomaa
- THL-Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Julio Sanjuan
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
- Biomedical Research Institute INCLIVA, Valencia, Spain
- Department of Psychiatry, School of Medicine, University of Valencia, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Marcos Leite Santoro
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
- Department of Morphology and Genetics, Laboratorio de Genetica, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Adam Savitz
- Neuroscience Therapeutic Area, Janssen Research and Development, Titusville, NJ, USA
| | - Ulrich Schall
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Priority Centre for Brain and Mental Health Research, University of Newcastle, Mater Hospital, McAuley Centre, Newcastle, New South Wales, Australia
| | - Rodney J Scott
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Division of Molecular Medicine, NSW Health Pathology North, Newcastle, New South Wales, Australia
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Sally Isabel Sharp
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Jianxin Shi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Larry J Siever
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- James J. Peters VA Medical Center, Bronx, NY, USA
| | - Engilbert Sigurdsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Psychiatry, Landspitali University Hospital, Reykjavik, Iceland
| | - Kang Sim
- West Region, Institute of Mental Health, Singapore, Singapore
- Yoo Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Nora Skarabis
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - Petr Slominsky
- Institute of Molecular Genetics of National Research Centre "Kurchatov Institute", Moscow, Russia
| | - Hon-Cheong So
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China
| | - Janet L Sobell
- Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Erik Söderman
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Helen J Stain
- School of Social and Health Sciences, Leeds Trinity University, Leeds, UK
- TIPS - Network for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
| | - Nils Eiel Steen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Agnes A Steixner-Kumar
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | | | - William S Stone
- Harvard Medical School Department of Psychiatry at Beth Israel Deaconess Medical Center, Boston, MA, USA
- Massachusetts Mental Health Center, Boston, MA, USA
| | | | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Eric Strengman
- Department of Medical Genetics, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - T Scott Stroup
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore, Republic of Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore
| | - Catherine A Sugar
- Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Jaana Suvisaari
- THL-Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Dragan M Svrakic
- Department of Psychiatry, Washington University, St Louis, MO, USA
| | - Neal R Swerdlow
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Jin P Szatkiewicz
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
| | - Thi Minh Tam Ta
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Atsushi Takahashi
- Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Chikashi Terao
- Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Florence Thibaut
- Université de Paris, Faculté de Médecine, Hôpital Cochin-Tarnier, Paris, France
- INSERM U1266, Institut de Psychiatrie et de Neurosciences, Paris, France
| | - Draga Toncheva
- Department of Medical Genetics, Medical University, Sofia, Bulgaria
- Bulgarian Academy of Science, Sofia, Bulgaria
| | - Paul A Tooney
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, New South Wales, Australia
| | - Silvia Torretta
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Sarah Tosato
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Gian Battista Tura
- Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Bruce I Turetsky
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Alp Üçok
- Department of Psychiatry, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Arne Vaaler
- Division of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Therese van Amelsvoort
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Ruud van Winkel
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Neurosciences, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium
| | - Juha Veijola
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - John Waddington
- Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - Anna Waterreus
- Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
- Centre for Clinical Research in Neuropsychiatry, University of Western Australia, Perth, Western Australia, Australia
| | - Bradley T Webb
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Nigel M Williams
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Brandon K Wormley
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Jing Qin Wu
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Zhida Xu
- Department of Psychiatry, GGz Centraal, Utrecht, The Netherlands
| | - Robert Yolken
- Stanley Neurovirology Laboratory, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Clement C Zai
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Wei Zhou
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Collaborative Innovation Center for Brain Science, Shanghai Jiao Tong University, Shanghai, China
| | - Feng Zhu
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Center for Translational Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Fritz Zimprich
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Eşref Cem Atbaşoğlu
- Department of Genetics and Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
| | - Muhammad Ayub
- Department of Psychiatry, Queens University Kingston, Kingston, Ontario, Canada
| | - Christian Benner
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Donald W Black
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Nicholas J Bray
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Gerome Breen
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nancy G Buccola
- School of Nursing, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - William F Byerley
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Wei J Chen
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan Town, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | | | - Benedicto Crespo-Facorro
- University of Sevilla, CIBERSAM IBiS, Seville, Spain
- Hospital Universitario Virgen del Rocio, Department of Psychiatry, Universidad del Sevilla, Seville, Spain
| | - Gary Donohoe
- Centre for Neuroimaging, Cognition and Genomics (NICOG), National University of Ireland Galway, Galway, Ireland
| | - Robert Freedman
- Department of Psychiatry, University of Colorado Denver, Aurora, CO, USA
| | - Cherrie Galletly
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
- Ramsay Health Care (SA) Mental Health, Adelaide, South Australia, Australia
- Northern Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Michael J Gandal
- Department of Psychiatry, Semel Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Massimo Gennarelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- Genetic Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - David M Hougaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Hai-Gwo Hwu
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
| | - Assen V Jablensky
- Centre for Clinical Research in Neuropsychiatry, University of Western Australia, Perth, Western Australia, Australia
| | - Steven A McCarroll
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Jennifer L Moran
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Preben B Mortensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Bertram Müller-Myhsok
- Max Planck Institute of Psychiatry, Munich, Germany
- Munich Cluster for Systems Neurology, Munich, Germany
- Department of Health Data Science, University of Liverpool, Liverpool, UK
| | - Amanda L Neil
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Michele T Pato
- Rutgers University, Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Rutgers University, New Jersey Medical School, Newark, NJ, USA
| | - Tracey L Petryshen
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry and Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Matti Pirinen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Department of Mathematics and Statistics, University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Ann E Pulver
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University, Baltimore, MD, USA
| | - Jeremy M Silverman
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- James J. Peters VA Medical Center, Bronx, NY, USA
| | - Jordan W Smoller
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry and Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Eli A Stahl
- Division of Psychiatric Genomics, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Regeneron Genetics Center, Orange, CA, USA
| | - Debby W Tsuang
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- VA Puget Sound Health Care System, Seattle, WA, USA
| | - Elisabet Vilella
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Shi-Heng Wang
- College of Public Health, China Medical University, Taichung, Taiwan
| | - Shuhua Xu
- State Key Laboratory of Genetic Engineering and Ministry of Education (MOE) Key Laboratory of Contemporary Anthropology, Collaborative Innovation Center of Genetics and Development, Human Phenome Institute, School of Life Sciences, Fudan University, Shanghai, China
- School of Life Science and Technology, ShanghaiTech University, Shanghai, China
- Center for Excellence in Animal Evolution and Genetics, Chinese Academy of Sciences, Kunming, China
| | - Rolf Adolfsson
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden
| | - Celso Arango
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
- Department of Psychiatry, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
| | - Sintia Iole Belangero
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
- Department of Morphology and Genetics, Laboratorio de Genetica, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Anders D Børglum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Biomedicine and Centre for Integrative Sequencing (iSEQ), Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - David Braff
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- VISN 22, Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
| | - Elvira Bramon
- Division of Psychiatry, Department of Mental Health Neuroscience, University College London, London, UK
| | - Joseph D Buxbaum
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Jorge A Cervilla
- Department of Psychiatry, San Cecilio University Hospital, University of Granada, Granada, Spain
| | - Sven Cichon
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Neuroscience and Medicine (INM-1), Research Center Juelich, Juelich, Germany
| | | | - Aiden Corvin
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - David Curtis
- UCL Genetics Institute, University College London, London, UK
- Centre for Psychiatry, Queen Mary University London, London, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Enrico Domenici
- Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Hannelore Ehrenreich
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Valentina Escott-Price
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
- Dementia Research Institute, Cardiff University, Cardiff, UK
| | - Tõnu Esko
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Ayman H Fanous
- Department of Psychiatry, Veterans Affairs New York Harbor Healthcare System, New York, NY, USA
- Department of Psychiatry, Phoenix VA Healthcare System, Phoenix, AZ, USA
- Banner-University Medical Center, Phoenix, AZ, USA
| | - Anna Gareeva
- Department of Human Molecular Genetics of the Institute of Biochemistry and Genetics of the Ufa Federal Research Center of the Russian Academy of Sciences (IBG UFRC RAS), Ufa, Russia
- Federal State Educational Institution of Highest Education Bashkir State Medical University of Public Health Ministry of Russian Federation (BSMU), Ufa, Russia
| | - Micha Gawlik
- Department of Psychiatry, Psychosomatics and Psychotherapy, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Pablo V Gejman
- Center for Psychiatric Genetics, NorthShore University HealthSystem, Evanston, IL, USA
- Department of Psychiatry and Behavioral Neurosciences, The University of Chicago, Chicago, IL, USA
| | - Michael Gill
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - Stephen J Glatt
- Psychiatric Genetic Epidemiology and Neurobiology Laboratory (PsychGENe lab), Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Vera Golimbet
- Mental Health Research Center, Moscow, Russian Federation
| | - Kyung Sue Hong
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Christina M Hultman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Steven E Hyman
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA
| | - Nakao Iwata
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake Aichi, Japan
| | - Erik G Jönsson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - René S Kahn
- University Medical Center Utrecht, Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, Utrecht, The Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - James L Kennedy
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Elza Khusnutdinova
- Department of Human Molecular Genetics of the Institute of Biochemistry and Genetics of the Ufa Federal Research Center of the Russian Academy of Sciences (IBG UFRC RAS), Ufa, Russia
- Federal State Educational Institution of Highest Education Bashkir State Medical University of Public Health Ministry of Russian Federation (BSMU), Ufa, Russia
| | - George Kirov
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - James A Knowles
- Department of Psychiatry and Zilkha Neurogenetics Institute, Keck School of Medicine at University of Southern California, Los Angeles, CA, USA
- Department of Cell Biology, State University of New York, Downstate Health Sciences University, New York, NY, USA
| | - Marie-Odile Krebs
- INSERM U1266, Institute of Psychiatry and Neuroscience of Paris, Université de Paris, GHU Paris Psychiatrie & Neurosciences, Paris, France
| | - Claudine Laurent-Levinson
- Faculté de Médecine Sorbonne Université, Groupe de Recherche Clinique no. 15 - Troubles Psychiatriques et Développement (PSYDEV), Department of Child and Adolescent Psychiatry, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
- Centre de Référence des Maladies Rares à Expression Psychiatrique, Department of Child and Adolescent Psychiatry, AP-HP Sorbonne Université, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
| | - Jimmy Lee
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
- Neuroscience and Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Todd Lencz
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Douglas F Levinson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Qingqin S Li
- Neuroscience Therapeutic Area, Janssen Research and Development, Titusville, NJ, USA
| | - Jianjun Liu
- Human Genetics, Genome Institute of Singapore, A*STAR, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Anil K Malhotra
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Dheeraj Malhotra
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, F. Hoffman-La Roche, Basel, Switzerland
| | - Andrew McIntosh
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - Andrew McQuillin
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Paulo R Menezes
- Department of Preventative Medicine, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil
| | - Vera A Morgan
- Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
- Centre for Clinical Research in Neuropsychiatry, University of Western Australia, Perth, Western Australia, Australia
| | - Derek W Morris
- Centre for Neuroimaging, Cognition and Genomics (NICOG), National University of Ireland Galway, Galway, Ireland
| | - Bryan J Mowry
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Queensland, Australia
| | - Robin M Murray
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | | | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - Roel A Ophoff
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Sara A Paciga
- Early Clinical Development, Pfizer Worldwide Research and Development, Groton, CT, USA
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Analytic and Translational Genetics Unit, Department of Medicine, Department of Neurology and Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Carlos N Pato
- Rutgers University, Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Rutgers University, New Jersey Medical School, Newark, NJ, USA
| | - Shengying Qin
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Collaborative Innovation Center for Brain Science, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Brien P Riley
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Margarita Rivera
- Department of Biochemistry and Molecular Biology II, Faculty of Pharmacy, University of Granada, Granada, Spain
- Institute of Neurosciences, Biomedical Research Center (CIBM), University of Granada, Granada, Spain
| | - Dan Rujescu
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Meram C Saka
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
| | - Alan R Sanders
- Center for Psychiatric Genetics, NorthShore University HealthSystem, Evanston, IL, USA
- Department of Psychiatry and Behavioral Neurosciences, The University of Chicago, Chicago, IL, USA
| | - Sibylle G Schwab
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Pak C Sham
- Centre for PanorOmic Sciences, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- State Key Laboratory of Brain and Cognitive Sciences, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Yongyong Shi
- Affiliated Hospital of Qingdao University and Biomedical Sciences Institute of Qingdao University (Qingdao Branch of SJTU Bio-X Institutes), Qingdao University, Qingdao, China
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Collaborative Innovation Center for Brain Science, Shanghai Jiao Tong University, Shanghai, China
| | - David St Clair
- Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | | | | | - Ming T Tsuang
- Center for Behavioral Genomics, Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Institute of Genomic Medicine, University of California San Diego, La Jolla, CA, USA
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands
| | - Marquis P Vawter
- Department of Psychiatry and Human Behavior, School of Medicine, University of California Irvine, Irvine, CA, USA
| | | | - Thomas Werge
- Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Copenhagen, Denmark
| | - Dieter B Wildenauer
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Western Australia, Australia
| | - Xin Yu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University) and Chinese Academy of Medical Sciences Research Unit, Beijing, China
| | - Weihua Yue
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University) and Chinese Academy of Medical Sciences Research Unit, Beijing, China
- PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Peter A Holmans
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Andrew J Pocklington
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Panos Roussos
- Department of Psychiatry, Pamela Sklar Division of Psychiatric Genomics, Friedman Brain Institute, Department of Genetics and Genomic Science and Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education, and Clinical Center (VISN 2 South), James J. Peters VA Medical Center, New York, NY, USA
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Matthijs Verhage
- Department of Clinical Genetics, Center for Neurogenomics and Cognitive Research, University Medical Center Amsterdam, Amsterdam, The Netherlands
- Department of Functional Genomics, Faculty of Exact Science, Center for Neurogenomics and Cognitive Research, VU University Amsterdam and VU Medical Center, Amsterdam, The Netherlands
| | - Peter M Visscher
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Jian Yang
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- School of Life Sciences, Westlake University, Hangzhou, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China
| | - Danielle Posthuma
- Department of Functional Genomics, Faculty of Exact Science, Center for Neurogenomics and Cognitive Research, VU University Amsterdam and VU Medical Center, Amsterdam, The Netherlands
| | - Ole A Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Michael J Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Naomi R Wray
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Mark J Daly
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Hailiang Huang
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Benjamin M Neale
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Patrick F Sullivan
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Stephan Ripke
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany.
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA.
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
| | - James T R Walters
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
| | - Michael C O'Donovan
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
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Talarico F, Costa GO, Ota VK, Santoro ML, Noto C, Gadelha A, Bressan R, Azevedo H, Belangero SI. Systems-Level Analysis of Genetic Variants Reveals Functional and Spatiotemporal Context in Treatment-resistant Schizophrenia. Mol Neurobiol 2022; 59:3170-3182. [DOI: 10.1007/s12035-022-02794-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/06/2022] [Indexed: 10/18/2022]
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Solmi M, Estradé A, Thompson T, Agorastos A, Radua J, Cortese S, Dragioti E, Leisch F, Vancampfort D, Thygesen LC, Aschauer H, Schloegelhofer M, Akimova E, Schneeberger A, Huber CG, Hasler G, Conus P, Cuénod KQD, von Känel R, Arrondo G, Fusar-Poli P, Gorwood P, Llorca PM, Krebs MO, Scanferla E, Kishimoto T, Rabbani G, Skonieczna-Żydecka K, Brambilla P, Favaro A, Takamiya A, Zoccante L, Colizzi M, Bourgin J, Kamiński K, Moghadasin M, Seedat S, Matthews E, Wells J, Vassilopoulou E, Gadelha A, Su KP, Kwon JS, Kim M, Lee TY, Papsuev O, Manková D, Boscutti A, Gerunda C, Saccon D, Righi E, Monaco F, Croatto G, Cereda G, Demurtas J, Brondino N, Veronese N, Enrico P, Politi P, Ciappolino V, Pfennig A, Bechdolf A, Meyer-Lindenberg A, Kahl KG, Domschke K, Bauer M, Koutsouleris N, Winter S, Borgwardt S, Bitter I, Balazs J, Czobor P, Unoka Z, Mavridis D, Tsamakis K, Bozikas VP, Tunvirachaisakul C, Maes M, Rungnirundorn T, Supasitthumrong T, Haque A, Brunoni AR, Costardi CG, Schuch FB, Polanczyk G, Luiz JM, Fonseca L, Aparicio LV, Valvassori SS, Nordentoft M, Vendsborg P, Hoffmann SH, Sehli J, Sartorius N, Heuss S, Guinart D, Hamilton J, Kane J, Rubio J, Sand M, Koyanagi A, Solanes A, Andreu-Bernabeu A, Cáceres ASJ, Arango C, Díaz-Caneja CM, Hidalgo-Mazzei D, Vieta E, Gonzalez-Peñas J, Fortea L, Parellada M, Fullana MA, Verdolini N, Fárková E, Janků K, Millan M, Honciuc M, Moniuszko-Malinowska A, Łoniewski I, Samochowiec J, Kiszkiel Ł, Marlicz M, Sowa P, Marlicz W, Spies G, Stubbs B, Firth J, Sullivan S, Darcin AE, Aksu H, Dilbaz N, Noyan O, Kitazawa M, Kurokawa S, Tazawa Y, Anselmi A, Cracco C, Machado AI, Estrade N, De Leo D, Curtis J, Berk M, Ward P, Teasdale S, Rosenbaum S, Marx W, Horodnic AV, Oprea L, Alexinschi O, Ifteni P, Turliuc S, Ciuhodaru T, Bolos A, Matei V, Nieman DH, Sommer I, van Os J, van Amelsvoort T, Sun CF, Guu TW, Jiao C, Zhang J, Fan J, Zou L, Yu X, Chi X, de Timary P, van Winke R, Ng B, Pena E, Arellano R, Roman R, Sanchez T, Movina L, Morgado P, Brissos S, Aizberg O, Mosina A, Krinitski D, Mugisha J, Sadeghi-Bahmani D, Sadeghi M, Hadi S, Brand S, Errazuriz A, Crossley N, Ristic DI, López-Jaramillo C, Efthymiou D, Kuttichira P, Kallivayalil RA, Javed A, Afridi MI, James B, Seb-Akahomen OJ, Fiedorowicz J, Carvalho AF, Daskalakis J, Yatham LN, Yang L, Okasha T, Dahdouh A, Gerdle B, Tiihonen J, Shin JI, Lee J, Mhalla A, Gaha L, Brahim T, Altynbekov K, Negay N, Nurmagambetova S, Jamei YA, Weiser M, Correll CU. Physical and mental health impact of COVID-19 on children, adolescents, and their families: The Collaborative Outcomes study on Health and Functioning during Infection Times - Children and Adolescents (COH-FIT-C&A). J Affect Disord 2022; 299:367-376. [PMID: 34606810 PMCID: PMC8486586 DOI: 10.1016/j.jad.2021.09.090] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 09/17/2021] [Accepted: 09/26/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND The COVID-19 pandemic has altered daily routines and family functioning, led to closing schools, and dramatically limited social interactions worldwide. Measuring its impact on mental health of vulnerable children and adolescents is crucial. METHODS The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT - www.coh-fit.com) is an on-line anonymous survey, available in 30 languages, involving >230 investigators from 49 countries supported by national/international professional associations. COH-FIT has thee waves (until the pandemic is declared over by the WHO, and 6-18 months plus 24-36 months after its end). In addition to adults, COH-FIT also includes adolescents (age 14-17 years), and children (age 6-13 years), recruited via non-probability/snowball and representative sampling and assessed via self-rating and parental rating. Non-modifiable/modifiable risk factors/treatment targets to inform prevention/intervention programs to promote health and prevent mental and physical illness in children and adolescents will be generated by COH-FIT. Co-primary outcomes are changes in well-being (WHO-5) and a composite psychopathology P-Score. Multiple behavioral, family, coping strategy and service utilization factors are also assessed, including functioning and quality of life. RESULTS Up to June 2021, over 13,000 children and adolescents from 59 countries have participated in the COH-FIT project, with representative samples from eleven countries. LIMITATIONS Cross-sectional and anonymous design. CONCLUSIONS Evidence generated by COH-FIT will provide an international estimate of the COVID-19 effect on children's, adolescents' and families', mental and physical health, well-being, functioning and quality of life, informing the formulation of present and future evidence-based interventions and policies to minimize adverse effects of the present and future pandemics on youth.
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Affiliation(s)
- Marco Solmi
- University of Ottawa, Department of Psychiatry, Ontario, Canada; The Ottawa Hospital, Department of Mental Health, Ontario, Canada; University of Ottawa, Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program, Ottawa Ontario; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology& Neuroscience, King's College London, London, United Kingdom; Centre for Innovation in Mental Health-Developmental Lab, School of Psychology, University of Southampton, and NHS Trust, Southampton, United Kingdom.
| | - Andrés Estradé
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology& Neuroscience, King's College London, London, United Kingdom; Universidad Católica, Department of Psychology, Montevideo, Uruguay.
| | - Trevor Thompson
- University of Greenwich, School of Human Sciences, London, United Kingdom.
| | - Agorastos Agorastos
- Aristotle University of Thessaloniki, II. Dept. of Psychiatry, Division of Neurosciences, Medical School, Faculty of Health Sciences, Greece.
| | - Joaquim Radua
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology& Neuroscience, King's College London, London, United Kingdom; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Imaging of Mood- and Anxiety-Related Disorders (IMARD), CIBERSAM, Barcelona, Spain; Karolinska Institutet, Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Stockholm, Sweden.
| | - Samuele Cortese
- University of Southampton, Centre for Innovation in Mental Health, Southampton, United Kingdom.
| | - Elena Dragioti
- Linköping University, Pain and Rehabilitation Centre and Department of Health, Medicine and Caring Sciences, Linköping, Sweden; University of Ioannina, Research Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, Ioannina, Greece.
| | - Friedrich Leisch
- University of Natural Resources and Life Sciences, Wien, Austria.
| | - Davy Vancampfort
- Katholieke Universiteit Leuven (KU Leuven), Department of Rehabilitation Sciences, Leuven, Belgium.
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Denmark.
| | - Harald Aschauer
- BioPsyC - Biopsychosocial Corporation, Non-profit association for Research Funding Ltd., Vienna, Austria.
| | - Monika Schloegelhofer
- BioPsyC - Biopsychosocial Corporation, Non-profit association for Research Funding Ltd., Vienna, Austria.
| | - Elena Akimova
- BioPsyC - Biopsychosocial Corporation, Non-profit association for Research Funding Ltd., Vienna, Austria.
| | | | - Christian G Huber
- University of Basel, Universitäre Psychiatrische Kliniken Basel (UPK), Basel, Switzerland.
| | - Gregor Hasler
- University of Fribourg, Fribourg Network of Mental Health (RFSM), Fribourg, Switzerland.
| | - Philippe Conus
- University of Lausanne, Department of Psychiatry, Lausanne, Switzerland.
| | - Kim Q Do Cuénod
- University of Lausanne, Department of Psychiatry, Lausanne, Switzerland.
| | - Roland von Känel
- University Hospital Zurich, Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, Switzerland.
| | - Gonzalo Arrondo
- University of Southampton, Centre for Innovation in Mental Health, Southampton, United Kingdom; University of Navarra, Mind-Brain Group, Institute for Culture and Society (ICS), Pamplona, Spain.
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology& Neuroscience, King's College London, London, United Kingdom; OASIS service, South London and Maudsley NHS Foundation Trust, London, United Kingdom; University of Pavia, Department of Brain and Behavioral Sciences, Pavia, Italy.
| | - Philip Gorwood
- Université de Paris, CMME, GHU Paris Psychiatrie et Neurosciences, Paris, France; Institute de Psychiatrie et Neuroscience de Paris, INSERM U1266, F-75014, Paris, France.
| | - Pierre-Michel Llorca
- Université Clermont Auvergne, CHU Clermont-Ferrand, Service de Psychiatrie B, Clermont-Ferrand, France.
| | - Marie-Odile Krebs
- Institute de Psychiatrie et Neuroscience de Paris, INSERM U1266, F-75014, Paris, France; Université de Paris, PEPIT, GHU Paris Psychiatrie et Neuroscience, Paris, France.
| | - Elisabetta Scanferla
- Université de Paris, CMME, GHU Paris Psychiatrie et Neurosciences, Paris, France.
| | - Taishiro Kishimoto
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan.
| | - Golam Rabbani
- The National Foundation of Mental Health of Bangladesh, Bangladesh.
| | | | - Paolo Brambilla
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, Milan, Italy.
| | - Angela Favaro
- University of Padua, Neurosciences Department, Padua, Italy.
| | - Akihiro Takamiya
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan.
| | - Leonardo Zoccante
- Integrated University Hospital of Verona, Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Verona, Italy.
| | - Marco Colizzi
- University of Verona, Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, Verona, Italy.
| | - Julie Bourgin
- Service de Psychiatrie de l'enfant et de l'adolescent, GHNE, 91440 Bures Sur Yvette, France.
| | - Karol Kamiński
- Medical University of Białystok, Department of Population Medicine and Lifestyle Diseases Prevention, Bialystok, Poland.
| | - Maryam Moghadasin
- Kharazmi University, Department of Clinical Psychology, Faculty of Psychology and Education, Tehran, Iran.
| | - Soraya Seedat
- Stellenbosch University, Department of Psychiatry, Faculty of Medicine and Health Sciences, South Africa.
| | - Evan Matthews
- Waterford Institute of Technology, School of Health Sciences, Waterford, Ireland.
| | - John Wells
- Waterford Institute of Technology, School of Health Sciences, Waterford, Ireland.
| | | | - Ary Gadelha
- Universidade Federal de São Paulo, Department of Psychiatry, São Paulo, Brazil.
| | - Kuan-Pin Su
- An-Nan Hospital, China Medical University, Department of Psychiatry, Tainan, Taiwan; Maastricht University, Department of Psychiatry and Neuropsychology, Maastricht, The Netherlands.
| | - Jun Soo Kwon
- Seoul National University College of Medicine, Department of Psychiatry, Seoul, Republic of Korea.
| | - Minah Kim
- Seoul National University Hospital, Department of Neuropsychiatry, Seoul, Republic of Korea.
| | - Tae Young Lee
- Pusan National University Yangsan Hospital, Department of Psychiatry, Yangsan, Republic of Korea.
| | - Oleg Papsuev
- Moscow Research Institute of Psychiatry, Moscow, Russia.
| | - Denisa Manková
- National Institute of Mental Health, Klecany, Czech Republic.
| | - Andrea Boscutti
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy.
| | | | - Diego Saccon
- AULSS4 Veneto Orientale, Addictions Department, Italy.
| | - Elena Righi
- University of Modena and Reggio Emilia, Department of Biomedical, Metabolic and Neural Sciences, Modena, Italy.
| | | | | | - Guido Cereda
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy.
| | - Jacopo Demurtas
- University of Modena and Reggio Emilia, Clinical and Experimental Medicine PhD Program, Modena, Italy.
| | - Natascia Brondino
- University of Pavia, Department of Brain and Behavioral Sciences, Pavia, Italy.
| | - Nicola Veronese
- University of Palermo, Department of Internal Medicine, Geriatrics Section, Palermo, Italy.
| | - Paolo Enrico
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy.
| | - Pierluigi Politi
- University of Pavia, Department of Brain and Behavioral Sciences, Pavia, Italy.
| | - Valentina Ciappolino
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, Milan, Italy.
| | - Andrea Pfennig
- Technische Universität Dresden, University Hospital Carl Gustav Carus, Department of Psychiatry and Psychotherapy, Dresden, Germany.
| | | | | | - Kai G Kahl
- Hannover Medical School, Department of Psychiatry, Social Psychiatry and Psychotherapy, Germany.
| | - Katharina Domschke
- University of Freiburg, Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany.
| | - Michael Bauer
- Technische Universität Dresden, University Hospital Carl Gustav Carus, Department of Psychiatry and Psychotherapy, Dresden, Germany.
| | | | - Sibylle Winter
- Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany.
| | | | - Istvan Bitter
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary.
| | - Judit Balazs
- Eotvos Lorand University, Institute of Psychology, Budapest, Hungary; Bjørknes University College, Oslo, Norway.
| | - Pal Czobor
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary.
| | - Zsolt Unoka
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary.
| | - Dimitris Mavridis
- University of Ioannina, Department of Primary Education, Ioannina, Greece.
| | - Konstantinos Tsamakis
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
| | - Vasilios P Bozikas
- Aristotle University of Thessaloniki, II. Dept. of Psychiatry, Division of Neurosciences, Medical School, Faculty of Health Sciences, Greece.
| | | | - Michael Maes
- Chulalongkorn University, Department of Psychiatry, Thailand.
| | | | | | - Ariful Haque
- The National Foundation of Mental Health of Bangladesh, Bangladesh.
| | - Andre R Brunoni
- Faculdade de Medicina da Universidade de São Paulo, Departments of Internal Medicine and Psychiatry, São Paulo, Brazil.
| | | | - Felipe Barreto Schuch
- Universidade Federal de Santa Maria, Department of Sports Methods and Techniques, Santa Maria, RS, Brazil.
| | - Guilherme Polanczyk
- Faculdade de Medicina da Universidade de São Paulo, Departments of Internal Medicine and Psychiatry, São Paulo, Brazil.
| | - Jhoanne Merlyn Luiz
- Universidade do Extremo Sul Catarinense, Translational Psychiatry Laboratory, Graduate Program in Health Sciences, Criciúma, SC, Brazil.
| | - Lais Fonseca
- Universidade Federal de São Paulo, Department of Psychiatry, São Paulo, Brazil.
| | - Luana V Aparicio
- Faculdade de Medicina da Universidade de São Paulo, Departments of Internal Medicine and Psychiatry, São Paulo, Brazil.
| | - Samira S Valvassori
- Universidade do Extremo Sul Catarinense, Translational Psychiatry Laboratory, Graduate Program in Health Sciences, Criciúma, SC, Brazil.
| | | | | | - Sofie Have Hoffmann
- National Institute of Public Health, University of Southern Denmark, Denmark.
| | - Jihed Sehli
- University of Fribourg, Fribourg Network of Mental Health (RFSM), Fribourg, Switzerland.
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes (AMH), Switzerland.
| | - Sabina Heuss
- FHNW University of Applied Sciences and Arts Northwestern Switzerland, Switzerland.
| | - Daniel Guinart
- The Zucker Hillside Hospital, Northwell Health, New York, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA; Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut de Neuropsiquiatria i Addiccions (INAD), Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Departament de Psiquiatria, Barcelona, Spain.
| | - Jane Hamilton
- University of Texas Health Science Center Houston, McGovern Medical School, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, USA.
| | - John Kane
- The Zucker Hillside Hospital, Northwell Health, New York, USA; Feinstein Institutes for Medical Research, New York, USA.
| | - Jose Rubio
- The Zucker Hillside Hospital, Northwell Health, New York, USA; Feinstein Institutes for Medical Research, New York, USA.
| | | | - Ai Koyanagi
- Parc Sanitari Sant Joan de Deu, Research and Development Unit, CIBERSAM, ICREA, Barcelona, Spain.
| | - Aleix Solanes
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Imaging of Mood- and Anxiety-Related Disorders (IMARD), CIBERSAM, Barcelona, Spain.
| | - Alvaro Andreu-Bernabeu
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain.
| | - Antonia San José Cáceres
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain.
| | - Celso Arango
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain.
| | - Covadonga M Díaz-Caneja
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain.
| | | | - Eduard Vieta
- University of Barcelona, Hospital Clínic, IDIBAPS, CIBERSAM, Barcelona, Spain.
| | - Javier Gonzalez-Peñas
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain.
| | - Lydia Fortea
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Imaging of Mood- and Anxiety-Related Disorders (IMARD), CIBERSAM, Barcelona, Spain.
| | - Mara Parellada
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain.
| | - Miquel A Fullana
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Imaging of Mood- and Anxiety-Related Disorders (IMARD), CIBERSAM, Barcelona, Spain.
| | - Norma Verdolini
- University of Barcelona, Hospital Clínic, Bipolar and Depressive Disorders Unit, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Spain.
| | - Eva Fárková
- National Institute of Mental Health, Klecany, Czech Republic.
| | - Karolina Janků
- National Institute of Mental Health, Klecany, Czech Republic.
| | - Mark Millan
- Institute de Recherché de Servier (IDRS), France.
| | - Mihaela Honciuc
- Université Clermont Auvergne, CHU Clermont-Ferrand, Service de Psychiatrie B, Clermont-Ferrand, France.
| | | | - Igor Łoniewski
- Pomeranian Medical University in Szczecin, Department of Biochemical Sciences, Szczecin, Poland; Sanprobi Sp. z o.o. Sp. k, Poland.
| | - Jerzy Samochowiec
- Pomeranian Medical University in Szczecin, Department of Psychiatry, Szczecin, Poland.
| | - Łukasz Kiszkiel
- University of Białystok, Institute of Sociology, Society and Cognition Unit, Białystok, Poland.
| | - Maria Marlicz
- Pomeranian Medical University in Szczecin, Department of Biochemical Sciences, Szczecin, Poland.
| | - Paweł Sowa
- Medical University of Białystok, Department of Population Medicine and Lifestyle Diseases Prevention, Bialystok, Poland.
| | - Wojciech Marlicz
- Pomeranian Medical University in Szczecin, Department of Gastroenterology, Szczecin, Poland; The Centre for Digestive Diseases Endoklinika, Szczecin, Poland.
| | - Georgina Spies
- Stellenbosch University, Department of Psychiatry, Faculty of Medicine and Health Sciences, South Africa.
| | | | - Joseph Firth
- University of Manchester, Division of Psychology and Mental Health, Manchester, United Kingdom.
| | | | - Asli Enez Darcin
- Istanbul Basaksehir Cam ve Sakura City Hospital, Department of Psychiatry, Istanbul, Turkey.
| | - Hatice Aksu
- Adnan Menderes University Department of Child and Adolescent Psychiatry, Aydın, Turkey.
| | - Nesrin Dilbaz
- Uskudar University, Department of Psychiatry and Psychology, Istanbul, Turkey.
| | - Onur Noyan
- Uskudar University, Department of Psychiatry and Psychology, Istanbul, Turkey.
| | - Momoko Kitazawa
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan.
| | - Shunya Kurokawa
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan.
| | - Yuki Tazawa
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan.
| | - Alejandro Anselmi
- Universidad Católica, Department of Psychology, Montevideo, Uruguay.
| | - Cecilia Cracco
- Universidad Católica, Department of Psychology, Montevideo, Uruguay.
| | - Ana Inés Machado
- Universidad Católica, Department of Psychology, Montevideo, Uruguay.
| | - Natalia Estrade
- Universidad Católica, Department of Psychology, Montevideo, Uruguay.
| | - Diego De Leo
- Griffith University, South East Queensland, Australia.
| | - Jackie Curtis
- Mindgardens Neuroscience Network, Sydney, Australia.
| | - Michael Berk
- Deakin University School of Medicine, Victoria, Australia.
| | - Philip Ward
- UNSW Sydney, School of Psychiatry, Sydney, Australia.
| | - Scott Teasdale
- Deakin University School of Medicine, Victoria, Australia.
| | | | - Wolfgang Marx
- Deakin University School of Medicine, Victoria, Australia.
| | - Adrian Vasile Horodnic
- University of Medicine and Pharmacy Grigore T. Popa, Faculty of Medicine, Iasi, Romania.
| | - Liviu Oprea
- University of Medicine and Pharmacy Grigore T. Popa, Faculty of Medicine, Iasi, Romania.
| | | | - Petru Ifteni
- Transilvania University of Brasov, Faculty of Medicine, Brasov, Romania.
| | - Serban Turliuc
- University of Medicine and Pharmacy Grigore T. Popa, Faculty of Medicine, Iasi, Romania.
| | | | - Alexandra Bolos
- University of Medicine and Pharmacy Grigore T. Popa, Faculty of Medicine, Iasi, Romania.
| | - Valentin Matei
- Psychiatry Department, University of Medicine and Pharmacy "Carol Davila" Bucharest, "Prof. Dr. Alexandru Obregia" Psychiatric Hospital, Bucharest, Romania.
| | - Dorien H Nieman
- Academisch Medisch Centrum Universiteit van Amsterdam, Amsterdam, The Netherlands.
| | - Iris Sommer
- University Medical Center Groningen, University of Groningen, Cognitive Neurosciences, Department of Biomedical Sciences of Cells & Systems, Groningen, The Netherlands; University Medical Center Groningen, University of Groningen, Department of Psychiatry, Groningen, The Netherlands.
| | - Jim van Os
- Utrecht University Medical Centre, Department of Psychiatry, Utrecht, The Netherlands.
| | - Therese van Amelsvoort
- Maastricht University, Department of Psychiatry and Neuropsychology, Maastricht, The Netherlands.
| | - Ching-Fang Sun
- China Medical University Hospital, Mind-Body Interface Research Center, Taichung, Taiwan; Department of Psychiatry and Behavioral Medicine, Carilion Clinic Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.
| | - Ta-Wei Guu
- China Medical University Beigang Hospital, Division of Psychiatry, Department of Internal Medicine, Taiwan.
| | - Can Jiao
- Shenzhen University, School of Psychology, Shenzhen, China.
| | - Jieting Zhang
- Shenzhen University, School of Psychology, Shenzhen, China.
| | - Jialin Fan
- Shenzhen University, School of Psychology, Shenzhen, China.
| | - Liye Zou
- Shenzhen University, School of Psychology, Shenzhen, China.
| | - Xin Yu
- Peking University Institute of Mental Health, Department of Public Mental Health, Pekin, China.
| | - Xinli Chi
- Shenzhen University, School of Psychology, Shenzhen, China.
| | - Philippe de Timary
- UCLouvain, Institute of Neuroscience and Cliniques Universitaires Saint-Luc, Department of Adult Psychiatry, Brussels, Belgium.
| | - Ruud van Winke
- Katholieke Universiteit Leuven (KU Leuven), Department of Neurosciences, Leuven, Belgium.
| | | | | | | | | | | | - Larisa Movina
- Moscow Research Institute of Psychiatry, Moscow, Russia.
| | - Pedro Morgado
- University of Minho, Life and Health Sciences Research Institute (ICVS), School of Medicine, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga Guimarães, Portugal.
| | - Sofia Brissos
- Lisbon's Psychiatric Hospital Centre, Department of Psychiatry, Portugal.
| | - Oleg Aizberg
- Belarusian Medical Academy of Postgraduate Education, Belarus.
| | - Anna Mosina
- Clienia AG, Wetzikon Psychiatric Centre, Switzerland.
| | | | - James Mugisha
- Kyambogo University, Department of Sociology and Social Administration, Kampala, Uganda.
| | - Dena Sadeghi-Bahmani
- Stanford University, Department of Psychology, California, USA; Universitäre Psychiatrische Kliniken Basel (UPK), Center of Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland.
| | - Masoud Sadeghi
- Kermanshah University of Medical Sciences, Medical Biology Research Center, Kermanshah, Iran.
| | | | - Serge Brand
- Universitäre Psychiatrische Kliniken Basel (UPK), Center of Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland; University of Basel, Department of Sport, Exercise, and Health, Division of Sport Science and Psychosocial Health, Basel, Switzerland; Kermanshah University of Medical Sciences, Substance Abuse Prevention Research Center, Kermanshah, Iran; Kermanshah University of Medical Sciences, Sleep Disorders Research Center, Kermanshah, Iran; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran.
| | - Antonia Errazuriz
- Pontificia Universidad Católica de Chile, Department of Psychiatry, School of Medicine, Santiago, Chile.
| | - Nicolas Crossley
- Pontificia Universidad Católica de Chile, Department of Psychiatry, School of Medicine, Santiago, Chile.
| | - Dragana Ignjatovic Ristic
- University of Kragujevac, Department of Psychiatry, Faculty of Medical Sciences, Kragujevac, Serbia.
| | | | - Dimitris Efthymiou
- University of Nicosia, Department of Life and Health Sciences, Nicosia, Cyprus.
| | | | | | - Afzal Javed
- Chairman, Pakistan Psychiatric Research Centre-Fountain House, Lahore, Pakistan.
| | - Muhammad Iqbal Afridi
- Dean, Faculty of Psychiatry, College of Physicians and Surgeons, Pakistan; Dean, Jinnah Postgraduate Medical Centre, Karachi, Pakistan; Dean, Faculty of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan.
| | - Bawo James
- Federal Neuropsychiatric Hospital, Department of Clinical Services, Benin-City, Nigeria.
| | | | - Jess Fiedorowicz
- University of Ottawa, Department of Psychiatry, Ontario, Canada.
| | | | | | | | - Lin Yang
- University of Calgary, Alberta Health Services, Calgary, Canada.
| | - Tarek Okasha
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egyp.
| | - Aïcha Dahdouh
- Oran 1 University, Department of Psychiatry-Addictology, Oran, Algeria.
| | - Björn Gerdle
- Linköping University, Pain and Rehabilitation Centre and Department of Health, Medicine and Caring Sciences, Linköping, Sweden.
| | - Jari Tiihonen
- Karolinska Institutet, Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Stockholm, Sweden.
| | - Jae Il Shin
- Yonsei University College of Medicine, Department of Pediatrics, Seoul, South Korea.
| | - Jinhee Lee
- Yonsei University Wonju College of Medicine, Department of Psychiatry, Wonju, South Korea.
| | - Ahmed Mhalla
- University of Monastir, Research Unit "Vulnerability to Mental Disorders" LR05ES10, Monastir, Tunisia.
| | - Lotfi Gaha
- University of Monastir, Research Unit "Vulnerability to Mental Disorders" LR05ES10, Monastir, Tunisia.
| | - Takoua Brahim
- University of Monastir, University Hospital of Monastir, Department of Psychiatry, Monastir, Tunisia.
| | - Kuanysh Altynbekov
- Republican Scientific and Practical Center of Mental Health, Kazakhstan.
| | - Nikolay Negay
- Republican Scientific and Practical Center of Mental Health, Kazakhstan.
| | | | | | | | - Christoph U Correll
- Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany; The Zucker Hillside Hospital, Northwell Health, New York, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA.
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Solmi M, Estradé A, Thompson T, Agorastos A, Radua J, Cortese S, Dragioti E, Leisch F, Vancampfort D, Thygesen LC, Aschauer H, Schloegelhofer M, Akimova E, Schneeberger A, Huber CG, Hasler G, Conus P, Cuénod KQD, von Känel R, Arrondo G, Fusar-Poli P, Gorwood P, Llorca PM, Krebs MO, Scanferla E, Kishimoto T, Rabbani G, Skonieczna-Żydecka K, Brambilla P, Favaro A, Takamiya A, Zoccante L, Colizzi M, Bourgin J, Kamiński K, Moghadasin M, Seedat S, Matthews E, Wells J, Vassilopoulou E, Gadelha A, Su KP, Kwon JS, Kim M, Lee TY, Papsuev O, Manková D, Boscutti A, Gerunda C, Saccon D, Righi E, Monaco F, Croatto G, Cereda G, Demurtas J, Brondino N, Veronese N, Enrico P, Politi P, Ciappolino V, Pfennig A, Bechdolf A, Meyer-Lindenberg A, Kahl KG, Domschke K, Bauer M, Koutsouleris N, Winter S, Borgwardt S, Bitter I, Balazs J, Czobor P, Unoka Z, Mavridis D, Tsamakis K, Bozikas VP, Tunvirachaisakul C, Maes M, Rungnirundorn T, Supasitthumrong T, Haque A, Brunoni AR, Costardi CG, Schuch FB, Polanczyk G, Luiz JM, Fonseca L, Aparicio LV, Valvassori SS, Nordentoft M, Vendsborg P, Hoffmann SH, Sehli J, Sartorius N, Heuss S, Guinart D, Hamilton J, Kane J, Rubio J, Sand M, Koyanagi A, Solanes A, Andreu-Bernabeu A, Cáceres ASJ, Arango C, Díaz-Caneja CM, Hidalgo-Mazzei D, Vieta E, Gonzalez-Peñas J, Fortea L, Parellada M, Fullana MA, Verdolini N, Fárková E, Janků K, Millan M, Honciuc M, Moniuszko-Malinowska A, Łoniewski I, Samochowiec J, Kiszkiel Ł, Marlicz M, Sowa P, Marlicz W, Spies G, Stubbs B, Firth J, Sullivan S, Darcin AE, Aksu H, Dilbaz N, Noyan O, Kitazawa M, Kurokawa S, Tazawa Y, Anselmi A, Cracco C, Machado AI, Estrade N, De Leo D, Curtis J, Berk M, Ward P, Teasdale S, Rosenbaum S, Marx W, Horodnic AV, Oprea L, Alexinschi O, Ifteni P, Turliuc S, Ciuhodaru T, Bolos A, Matei V, Nieman DH, Sommer I, van Os J, van Amelsvoort T, Sun CF, Guu TW, Jiao C, Zhang J, Fan J, Zou L, Yu X, Chi X, de Timary P, van Winke R, Ng B, Pena E, Arellano R, Roman R, Sanchez T, Movina L, Morgado P, Brissos S, Aizberg O, Mosina A, Krinitski D, Mugisha J, Sadeghi-Bahmani D, Sadeghi M, Hadi S, Brand S, Errazuriz A, Crossley N, Ristic DI, López-Jaramillo C, Efthymiou D, Kuttichira P, Kallivayalil RA, Javed A, Afridi MI, James B, Seb-Akahomen OJ, Fiedorowicz J, Carvalho AF, Daskalakis J, Yatham LN, Yang L, Okasha T, Dahdouh A, Gerdle B, Tiihonen J, Shin JI, Lee J, Mhalla A, Gaha L, Brahim T, Altynbekov K, Negay N, Nurmagambetova S, Jamei YA, Weiser M, Correll CU. The collaborative outcomes study on health and functioning during infection times in adults (COH-FIT-Adults): Design and methods of an international online survey targeting physical and mental health effects of the COVID-19 pandemic. J Affect Disord 2022; 299:393-407. [PMID: 34949568 PMCID: PMC8288233 DOI: 10.1016/j.jad.2021.07.048] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/11/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND . High-quality comprehensive data on short-/long-term physical/mental health effects of the COVID-19 pandemic are needed. METHODS . The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) is an international, multi-language (n=30) project involving >230 investigators from 49 countries/territories/regions, endorsed by national/international professional associations. COH-FIT is a multi-wave, on-line anonymous, cross-sectional survey [wave 1: 04/2020 until the end of the pandemic, 12 months waves 2/3 starting 6/24 months threreafter] for adults, adolescents (14-17), and children (6-13), utilizing non-probability/snowball and representative sampling. COH-FIT aims to identify non-modifiable/modifiable risk factors/treatment targets to inform prevention/intervention programs to improve social/health outcomes in the general population/vulnerable subgrous during/after COVID-19. In adults, co-primary outcomes are change from pre-COVID-19 to intra-COVID-19 in well-being (WHO-5) and a composite psychopathology P-Score. Key secondary outcomes are a P-extended score, global mental and physical health. Secondary outcomes include health-service utilization/functioning, treatment adherence, functioning, symptoms/behaviors/emotions, substance use, violence, among others. RESULTS . Starting 04/26/2020, up to 14/07/2021 >151,000 people from 155 countries/territories/regions and six continents have participated. Representative samples of ≥1,000 adults have been collected in 15 countries. Overall, 43.0% had prior physical disorders, 16.3% had prior mental disorders, 26.5% were health care workers, 8.2% were aged ≥65 years, 19.3% were exposed to someone infected with COVID-19, 76.1% had been in quarantine, and 2.1% had been COVID 19-positive. LIMITATIONS . Cross-sectional survey, preponderance of non-representative participants. CONCLUSIONS . Results from COH-FIT will comprehensively quantify the impact of COVID-19, seeking to identify high-risk groups in need for acute and long-term intervention, and inform evidence-based health policies/strategies during this/future pandemics.
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Affiliation(s)
- Marco Solmi
- University of Ottawa, Department of Psychiatry, Ontario, Canada; The Ottawa Hospital, Department of Mental Health, Ontario, Canada; University of Ottawa, Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program, Ottawa Ontario; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology& Neuroscience, King's College London, London, United Kingdom; Centre for Innovation in Mental Health-Developmental Lab, School of Psychology, University of Southampton, and NHS Trust, Southampton, United Kingdom.
| | - Andrés Estradé
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology& Neuroscience, King's College London, London, United Kingdom; Universidad Católica, Department of Psychology, Montevideo, Uruguay.
| | - Trevor Thompson
- University of Greenwich, School of Human Sciences, London, United Kingdom.
| | - Agorastos Agorastos
- Aristotle University of Thessaloniki, II. Dept. of Psychiatry, Division of Neurosciences, Medical School, Faculty of Health Sciences, Greece.
| | - Joaquim Radua
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology& Neuroscience, King's College London, London, United Kingdom; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Imaging of Mood- and Anxiety-Related Disorders (IMARD), CIBERSAM, Barcelona, Spain; Karolinska Institutet, Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Stockholm, Sweden.
| | - Samuele Cortese
- University of Southampton, Centre for Innovation in Mental Health, Southampton, United Kingdom.
| | - Elena Dragioti
- Linköping University, Pain and Rehabilitation Centre and Department of Health, Medicine and Caring Sciences, Linköping, Sweden; University of Ioannina, Research Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, Ioannina, Greece.
| | - Friedrich Leisch
- University of Natural Resources and Life Sciences, Wien, Austria.
| | - Davy Vancampfort
- Katholieke Universiteit Leuven (KU Leuven), Department of Rehabilitation Sciences, Leuven, Belgium.
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Denmark.
| | - Harald Aschauer
- BioPsyC - Biopsychosocial Corporation, Non-profit association for Research Funding Ltd., Vienna, Austria.
| | - Monika Schloegelhofer
- BioPsyC - Biopsychosocial Corporation, Non-profit association for Research Funding Ltd., Vienna, Austria.
| | - Elena Akimova
- BioPsyC - Biopsychosocial Corporation, Non-profit association for Research Funding Ltd., Vienna, Austria.
| | | | - Christian G. Huber
- University of Basel, Universitäre Psychiatrische Kliniken Basel (UPK), Basel, Switzerland
| | - Gregor Hasler
- University of Fribourg, Fribourg Network of Mental Health (RFSM), Fribourg, Switzerland.
| | - Philippe Conus
- University of Lausanne, Department of Psychiatry, Lausanne, Switzerland.
| | - Kim Q. Do Cuénod
- University of Lausanne, Department of Psychiatry, Lausanne, Switzerland
| | - Roland von Känel
- University Hospital Zurich, Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, Switzerland.
| | - Gonzalo Arrondo
- University of Southampton, Centre for Innovation in Mental Health, Southampton, United Kingdom; University of Navarra, Mind-Brain Group, Institute for Culture and Society (ICS), Pamplona, Spain.
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology& Neuroscience, King's College London, London, United Kingdom; OASIS service, South London and Maudsley NHS Foundation Trust, London, United Kingdom; University of Pavia, Department of Brain and Behavioral Sciences, Pavia, Italy.
| | - Philip Gorwood
- Université de Paris, CMME, GHU Paris Psychiatrie et Neurosciences, Paris, France; Institute de Psychiatrie et Neuroscience de Paris, INSERM U1266, F-75014, Paris, France.
| | - Pierre-Michel Llorca
- Université Clermont Auvergne, CHU Clermont-Ferrand, Service de Psychiatrie B, Clermont-Ferrand, France.
| | - Marie-Odile Krebs
- Institute de Psychiatrie et Neuroscience de Paris, INSERM U1266, F-75014, Paris, France; Université de Paris, PEPIT, GHU Paris Psychiatrie et Neuroscience, Paris, France.
| | - Elisabetta Scanferla
- Université de Paris, CMME, GHU Paris Psychiatrie et Neurosciences, Paris, France.
| | - Taishiro Kishimoto
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan.
| | - Golam Rabbani
- The National Foundation of Mental Health of Bangladesh, Bangladesh.
| | | | - Paolo Brambilla
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, Milan, Italy.
| | - Angela Favaro
- University of Padua, Neurosciences Department, Padua, Italy.
| | - Akihiro Takamiya
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan.
| | - Leonardo Zoccante
- Integrated University Hospital of Verona, Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Verona, Italy.
| | - Marco Colizzi
- University of Verona, Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, Verona, Italy.
| | - Julie Bourgin
- Service de Psychiatrie de l'enfant et de l'adolescent, GHNE, 91440 Bures Sur Yvette, France.
| | - Karol Kamiński
- Medical University of Białystok, Department of Population Medicine and Lifestyle Diseases Prevention, Bialystok, Poland.
| | - Maryam Moghadasin
- Kharazmi University, Department of Clinical Psychology, Faculty of Psychology and Education, Tehran, Iran.
| | - Soraya Seedat
- Stellenbosch University, Department of Psychiatry, Faculty of Medicine and Health Sciences, South Africa.
| | - Evan Matthews
- Waterford Institute of Technology, School of Health Sciences, Waterford, Ireland.
| | - John Wells
- Waterford Institute of Technology, School of Health Sciences, Waterford, Ireland.
| | | | - Ary Gadelha
- Universidade Federal de São Paulo, Department of Psychiatry, São Paulo, Brazil.
| | - Kuan-Pin Su
- An-Nan Hospital, China Medical University, Department of Psychiatry, Tainan, Taiwan; Maastricht University, Department of Psychiatry and Neuropsychology, Maastricht, The Netherlands.
| | - Jun Soo Kwon
- Seoul National University College of Medicine, Department of Psychiatry, Seoul, Republic of Korea.
| | - Minah Kim
- Seoul National University Hospital, Department of Neuropsychiatry, Seoul, Republic of Korea.
| | - Tae Young Lee
- Pusan National University Yangsan Hospital, Department of Psychiatry, Yangsan, Republic of Korea.
| | - Oleg Papsuev
- Moscow Research Institute of Psychiatry, Moscow, Russia.
| | - Denisa Manková
- National Institute of Mental Health, Klecany, Czech Republic.
| | - Andrea Boscutti
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy.
| | | | - Diego Saccon
- AULSS4 Veneto Orientale, Addictions Department, Italy.
| | - Elena Righi
- University of Modena and Reggio Emilia, Department of Biomedical, Metabolic and Neural Sciences, Modena, Italy.
| | | | | | - Guido Cereda
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy.
| | - Jacopo Demurtas
- University of Modena and Reggio Emilia, Clinical and Experimental Medicine PhD Program, Modena, Italy.
| | - Natascia Brondino
- University of Pavia, Department of Brain and Behavioral Sciences, Pavia, Italy.
| | - Nicola Veronese
- University of Palermo, Department of Internal Medicine, Geriatrics Section, Palermo, Italy.
| | - Paolo Enrico
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy.
| | - Pierluigi Politi
- University of Pavia, Department of Brain and Behavioral Sciences, Pavia, Italy.
| | - Valentina Ciappolino
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, Milan, Italy.
| | - Andrea Pfennig
- Technische Universität Dresden, University Hospital Carl Gustav Carus, Department of Psychiatry and Psychotherapy, Dresden, Germany.
| | | | | | - Kai G. Kahl
- Hannover Medical School, Department of Psychiatry, Social Psychiatry and Psychotherapy, Germany
| | - Katharina Domschke
- University of Freiburg, Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany.
| | - Michael Bauer
- Technische Universität Dresden, University Hospital Carl Gustav Carus, Department of Psychiatry and Psychotherapy, Dresden, Germany.
| | | | - Sibylle Winter
- Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany.
| | | | - Istvan Bitter
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary.
| | - Judit Balazs
- Eotvos Lorand University, Institute of Psychology, Budapest, Hungary; Bjørknes University College, Oslo, Norway.
| | - Pal Czobor
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary.
| | - Zsolt Unoka
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary.
| | - Dimitris Mavridis
- University of Ioannina, Department of Primary Education, Ioannina, Greece.
| | - Konstantinos Tsamakis
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
| | - Vasilios P. Bozikas
- Aristotle University of Thessaloniki, II. Dept. of Psychiatry, Division of Neurosciences, Medical School, Faculty of Health Sciences, Greece
| | | | - Michael Maes
- Chulalongkorn University, Department of Psychiatry, Thailand.
| | | | | | - Ariful Haque
- The National Foundation of Mental Health of Bangladesh, Bangladesh.
| | - Andre R. Brunoni
- Faculdade de Medicina da Universidade de São Paulo, Departments of Internal Medicine and Psychiatry, São Paulo, Brazil
| | | | - Felipe Barreto Schuch
- Universidade Federal de Santa Maria, Department of Sports Methods and Techniques, Santa Maria, RS, Brazil.
| | - Guilherme Polanczyk
- Faculdade de Medicina da Universidade de São Paulo, Departments of Internal Medicine and Psychiatry, São Paulo, Brazil.
| | - Jhoanne Merlyn Luiz
- Universidade do Extremo Sul Catarinense, Translational Psychiatry Laboratory, Graduate Program in Health Sciences, Criciúma, SC, Brazil.
| | - Lais Fonseca
- Universidade Federal de São Paulo, Department of Psychiatry, São Paulo, Brazil.
| | - Luana V. Aparicio
- Faculdade de Medicina da Universidade de São Paulo, Departments of Internal Medicine and Psychiatry, São Paulo, Brazil
| | - Samira S. Valvassori
- Universidade do Extremo Sul Catarinense, Translational Psychiatry Laboratory, Graduate Program in Health Sciences, Criciúma, SC, Brazil
| | | | | | - Sofie Have Hoffmann
- National Institute of Public Health, University of Southern Denmark, Denmark.
| | - Jihed Sehli
- University of Fribourg, Fribourg Network of Mental Health (RFSM), Fribourg, Switzerland.
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes (AMH), Switzerland.
| | - Sabina Heuss
- FHNW University of Applied Sciences and Arts Northwestern Switzerland, Switzerland.
| | - Daniel Guinart
- The Zucker Hillside Hospital, Northwell Health, New York, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA; Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut de Neuropsiquiatria i Addiccions (INAD), Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Departament de Psiquiatria, Barcelona, Spain.
| | - Jane Hamilton
- University of Texas Health Science Center Houston, McGovern Medical School, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, USA.
| | - John Kane
- The Zucker Hillside Hospital, Northwell Health, New York, USA; Feinstein Institutes for Medical Research, New York, USA.
| | - Jose Rubio
- The Zucker Hillside Hospital, Northwell Health, New York, USA; Feinstein Institutes for Medical Research, New York, USA.
| | | | - Ai Koyanagi
- Parc Sanitari Sant Joan de Deu, Research and Development Unit, CIBERSAM, ICREA, Barcelona, Spain.
| | - Aleix Solanes
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Imaging of Mood- and Anxiety-Related Disorders (IMARD), CIBERSAM, Barcelona, Spain.
| | - Alvaro Andreu-Bernabeu
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain.
| | - Antonia San José Cáceres
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain.
| | - Celso Arango
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain.
| | - Covadonga M. Díaz-Caneja
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain
| | | | - Eduard Vieta
- University of Barcelona, Hospital Clínic, IDIBAPS, CIBERSAM, Barcelona, Spain.
| | - Javier Gonzalez-Peñas
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain.
| | - Lydia Fortea
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Imaging of Mood- and Anxiety-Related Disorders (IMARD), CIBERSAM, Barcelona, Spain.
| | - Mara Parellada
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain.
| | - Miquel A. Fullana
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Imaging of Mood- and Anxiety-Related Disorders (IMARD), CIBERSAM, Barcelona, Spain
| | - Norma Verdolini
- University of Barcelona, Hospital Clínic, Bipolar and Depressive Disorders Unit, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Spain.
| | - Eva Fárková
- National Institute of Mental Health, Klecany, Czech Republic.
| | - Karolina Janků
- National Institute of Mental Health, Klecany, Czech Republic.
| | - Mark Millan
- Institute de Recherché de Servier (IDRS), France.
| | - Mihaela Honciuc
- Université Clermont Auvergne, CHU Clermont-Ferrand, Service de Psychiatrie B, Clermont-Ferrand, France.
| | | | - Igor Łoniewski
- Pomeranian Medical University in Szczecin, Department of Biochemical Sciences, Szczecin, Poland; Sanprobi Sp. z o.o. Sp. k, Poland.
| | - Jerzy Samochowiec
- Pomeranian Medical University in Szczecin, Department of Psychiatry, Szczecin, Poland.
| | - Łukasz Kiszkiel
- University of Białystok, Institute of Sociology, Society and Cognition Unit, Białystok, Poland.
| | - Maria Marlicz
- Pomeranian Medical University in Szczecin, Department of Biochemical Sciences, Szczecin, Poland.
| | - Paweł Sowa
- Medical University of Białystok, Department of Population Medicine and Lifestyle Diseases Prevention, Bialystok, Poland.
| | - Wojciech Marlicz
- Pomeranian Medical University in Szczecin, Department of Gastroenterology, Szczecin, Poland; The Centre for Digestive Diseases Endoklinika, Szczecin, Poland.
| | - Georgina Spies
- Stellenbosch University, Department of Psychiatry, Faculty of Medicine and Health Sciences, South Africa.
| | | | - Joseph Firth
- University of Manchester, Division of Psychology and Mental Health, Manchester, United Kingdom.
| | | | - Asli Enez Darcin
- Istanbul Basaksehir Cam ve Sakura City Hospital, Department of Psychiatry, Istanbul, Turkey.
| | - Hatice Aksu
- Adnan Menderes University Department of Child and Adolescent Psychiatry, Aydın, Turkey.
| | - Nesrin Dilbaz
- Uskudar University, Department of Psychiatry and Psychology, Istanbul, Turkey.
| | - Onur Noyan
- Uskudar University, Department of Psychiatry and Psychology, Istanbul, Turkey.
| | - Momoko Kitazawa
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan.
| | - Shunya Kurokawa
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan.
| | - Yuki Tazawa
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan.
| | - Alejandro Anselmi
- Universidad Católica, Department of Psychology, Montevideo, Uruguay.
| | - Cecilia Cracco
- Universidad Católica, Department of Psychology, Montevideo, Uruguay.
| | - Ana Inés Machado
- Universidad Católica, Department of Psychology, Montevideo, Uruguay.
| | - Natalia Estrade
- Universidad Católica, Department of Psychology, Montevideo, Uruguay.
| | - Diego De Leo
- Griffith University, South East Queensland, Australia.
| | - Jackie Curtis
- Mindgardens Neuroscience Network, Sydney, Australia.
| | - Michael Berk
- Deakin University School of Medicine, Victoria, Australia.
| | - Philip Ward
- UNSW Sydney, School of Psychiatry, Sydney, Australia.
| | - Scott Teasdale
- Deakin University School of Medicine, Victoria, Australia.
| | | | - Wolfgang Marx
- Deakin University School of Medicine, Victoria, Australia.
| | - Adrian Vasile Horodnic
- University of Medicine and Pharmacy Grigore T. Popa, Faculty of Medicine, Iasi, Romania.
| | - Liviu Oprea
- University of Medicine and Pharmacy Grigore T. Popa, Faculty of Medicine, Iasi, Romania.
| | | | - Petru Ifteni
- Transilvania University of Brasov, Faculty of Medicine, Brasov, Romania.
| | - Serban Turliuc
- University of Medicine and Pharmacy Grigore T. Popa, Faculty of Medicine, Iasi, Romania.
| | | | - Alexandra Bolos
- University of Medicine and Pharmacy Grigore T. Popa, Faculty of Medicine, Iasi, Romania.
| | - Valentin Matei
- Psychiatry Department, University of Medicine and Pharmacy "Carol Davila" Bucharest, "Prof. Dr. Alexandru Obregia" Psychiatric Hospital, Bucharest, Romania.
| | - Dorien H. Nieman
- Academisch Medisch Centrum Universiteit van Amsterdam, Amsterdam, The Netherlands
| | - Iris Sommer
- University Medical Center Groningen, University of Groningen, Cognitive Neurosciences, Department of Biomedical Sciences of Cells & Systems, Groningen, The Netherlands; University Medical Center Groningen, University of Groningen, Department of Psychiatry, Groningen, The Netherlands.
| | - Jim van Os
- Utrecht University Medical Centre, Department of Psychiatry, Utrecht, The Netherlands.
| | - Therese van Amelsvoort
- Maastricht University, Department of Psychiatry and Neuropsychology, Maastricht, The Netherlands.
| | - Ching-Fang Sun
- China Medical University Hospital, Mind-Body Interface Research Center, Taichung, Taiwan; Department of Psychiatry and Behavioral Medicine, Carilion Clinic Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.
| | - Ta-wei Guu
- China Medical University Beigang Hospital, Division of Psychiatry, Department of Internal Medicine, Taiwan
| | - Can Jiao
- Shenzhen University, School of Psychology, Shenzhen, China.
| | - Jieting Zhang
- Shenzhen University, School of Psychology, Shenzhen, China.
| | - Jialin Fan
- Shenzhen University, School of Psychology, Shenzhen, China.
| | - Liye Zou
- Shenzhen University, School of Psychology, Shenzhen, China.
| | - Xin Yu
- Peking University Institute of Mental Health, Department of Public Mental Health, Pekin, China.
| | - Xinli Chi
- Shenzhen University, School of Psychology, Shenzhen, China.
| | - Philippe de Timary
- UCLouvain, Institute of Neuroscience and Cliniques Universitaires Saint-Luc, Department of Adult Psychiatry, Brussels, Belgium.
| | - Ruud van Winke
- Katholieke Universiteit Leuven (KU Leuven), Department of Neurosciences, Leuven, Belgium.
| | | | | | | | | | | | - Larisa Movina
- Moscow Research Institute of Psychiatry, Moscow, Russia.
| | - Pedro Morgado
- University of Minho, Life and Health Sciences Research Institute (ICVS), School of Medicine, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga Guimarães, Portugal.
| | - Sofia Brissos
- Lisbon's Psychiatric Hospital Centre, Department of Psychiatry, Portugal.
| | - Oleg Aizberg
- Belarusian Medical Academy of Postgraduate Education, Belarus.
| | - Anna Mosina
- Clienia AG, Wetzikon Psychiatric Centre, Switzerland.
| | | | - James Mugisha
- Kyambogo University, Department of Sociology and Social Administration, Kampala, Uganda.
| | - Dena Sadeghi-Bahmani
- Stanford University, Department of Psychology, California, USA; Universitäre Psychiatrische Kliniken Basel (UPK), Center of Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland.
| | - Masoud Sadeghi
- Kermanshah University of Medical Sciences, Medical Biology Research Center, Kermanshah, Iran.
| | | | - Serge Brand
- Universitäre Psychiatrische Kliniken Basel (UPK), Center of Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland; University of Basel, Department of Sport, Exercise, and Health, Division of Sport Science and Psychosocial Health, Basel, Switzerland; Kermanshah University of Medical Sciences, Substance Abuse Prevention Research Center, Kermanshah, Iran; Kermanshah University of Medical Sciences, Sleep Disorders Research Center, Kermanshah, Iran; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran.
| | - Antonia Errazuriz
- Pontificia Universidad Católica de Chile, Department of Psychiatry, School of Medicine, Santiago, Chile.
| | - Nicolas Crossley
- Pontificia Universidad Católica de Chile, Department of Psychiatry, School of Medicine, Santiago, Chile.
| | - Dragana Ignjatovic Ristic
- University of Kragujevac, Department of Psychiatry, Faculty of Medical Sciences, Kragujevac, Serbia.
| | | | - Dimitris Efthymiou
- University of Nicosia, Department of Life and Health Sciences, Nicosia, Cyprus.
| | | | | | - Afzal Javed
- Chairman, Pakistan Psychiatric Research Centre-Fountain House, Lahore, Pakistan.
| | - Muhammad Iqbal Afridi
- Dean, Faculty of Psychiatry, College of Physicians and Surgeons, Pakistan; Dean, Jinnah Postgraduate Medical Centre, Karachi, Pakistan; Dean, Faculty of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan.
| | - Bawo James
- Federal Neuropsychiatric Hospital, Department of Clinical Services, Benin-City, Nigeria.
| | | | - Jess Fiedorowicz
- University of Ottawa, Department of Psychiatry, Ontario, Canada.
| | | | | | | | - Lin Yang
- University of Calgary, Alberta Health Services, Calgary, Canada.
| | - Tarek Okasha
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egyp.
| | - Aïcha Dahdouh
- Oran 1 University, Department of Psychiatry-Addictology, Oran, Algeria.
| | - Björn Gerdle
- Linköping University, Pain and Rehabilitation Centre and Department of Health, Medicine and Caring Sciences, Linköping, Sweden.
| | - Jari Tiihonen
- Karolinska Institutet, Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Stockholm, Sweden.
| | - Jae Il Shin
- Yonsei University College of Medicine, Department of Pediatrics, Seoul, South Korea.
| | - Jinhee Lee
- Yonsei University Wonju College of Medicine, Department of Psychiatry, Wonju, South Korea.
| | - Ahmed Mhalla
- University of Monastir, Research Unit "Vulnerability to Mental Disorders" LR05ES10, Monastir, Tunisia.
| | - Lotfi Gaha
- University of Monastir, Research Unit "Vulnerability to Mental Disorders" LR05ES10, Monastir, Tunisia.
| | - Takoua Brahim
- University of Monastir, University Hospital of Monastir, Department of Psychiatry, Monastir, Tunisia.
| | - Kuanysh Altynbekov
- Republican Scientific and Practical Center of Mental Health, Kazakhstan.
| | - Nikolay Negay
- Republican Scientific and Practical Center of Mental Health, Kazakhstan.
| | | | | | | | - Christoph U. Correll
- Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany,The Zucker Hillside Hospital, Northwell Health, New York, USA,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA
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Terra T, Schafer JL, Pan PM, Costa AB, Caye A, Gadelha A, Miguel EC, Bressan RA, Rohde LA, Salum GA. Mental health conditions in Lesbian, Gay, Bisexual, Transgender, Queer and Asexual youth in Brazil: A call for action. J Affect Disord 2022; 298:190-193. [PMID: 34715179 DOI: 10.1016/j.jad.2021.10.108] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/07/2021] [Accepted: 10/23/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Lesbian, Gay, Bisexual, Transgender, Queer, and Asexual (LGBTQA+) youth have a greater chance of experiencing stressful life events when compared to cisgender heterosexual peers, which can lead to mental health problems. We aimed to estimate the prevalence of mental disorders among LGBTQA+ youths from two large cities in Brazil. METHODS Participants were 13-22 years old youths from the 3rd wave of the Brazilian High-Risk Cohort for Psychiatric Disorders (n = 1475). Mental disorders were assessed using the Development and Well-Being Behavior Assessment. Sexual orientation and gender identity were assessed using a self-report confidential questionnaire. Data were analyzed through logistic regressions (adjusting for sociodemographic) using sampling weights to account for attrition and our oversampling high-risk design. RESULTS 15.18% of the sample described themselves as LGBTQA+. The LGBTQA+ group presented higher rates of anxiety disorders (30.14% vs. 13.37%; OR = 3.37; 95%CI:2.51-4.50), depressive disorders (27.75% vs. 15.34%; OR = 2.17; 95%CI:1.60-2.93) and post-traumatic stress disorder (4.98% vs. 2.25%; OR = 4.20; 95%CI:2.24-7.82), if compared with the cisgender heterosexual group. No difference was found for conduct disorders (2.97% vs. 5.21%; OR = 0.82; 95%CI:0.35-1.65) or attention deficit hyperactivity disorder (5.92% vs. 3.28%; OR = 1.56; 95%CI:0.83-2.79). LIMITATIONS Although recruitment was performed at 57 schools in the two cities, sampling was non-probabilistic and included only urban areas, which might bias prevalence estimates and group comparisons. CONCLUSIONS Our results elucidate the mental health disparities between LGBTQA+ people and cisgender heterosexuals in Brazil. It highlights the need to promote the inclusion of this population in policy formulation and support actions to mitigate the suffering related to sexual orientation and gender identity.
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Affiliation(s)
- Tauana Terra
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Section on Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Brazil; Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), CNPq, Brazil.
| | - Julia L Schafer
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Section on Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Brazil; Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), CNPq, Brazil
| | - Pedro M Pan
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), CNPq, Brazil; Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Angelo Brandelli Costa
- Graduate Program in Psychology, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Arthur Caye
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Ary Gadelha
- Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil; Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Eurípedes C Miguel
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), CNPq, Brazil; Universidade de São Paulo (USP), São Paulo, Brazil
| | - Rodrigo A Bressan
- Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil; Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Luis A Rohde
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Section on Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Brazil; Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), CNPq, Brazil
| | - Giovanni A Salum
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Section on Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Brazil; Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), CNPq, Brazil
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Abstract
The COVID-19 pandemic mainly affected the most vulnerable individuals. Among those, patients with schizophrenia especially suffered from unexpected changes in their routines, barriers to treatment, and distress-related events. We conducted a narrative review using all available sources of information to describe the challenges faced by schizophrenia patients and their families in Brazil, including the strategies that have been adopted to tackle them. In addition, we analyzed public data on antipsychotic prescriptions and hospitalizations. It was found that digital prescriptions with extended expiration dates implemented during the pandemic in Brazil allowed patients to maintain their access to antipsychotics. Hospitalizations among patients with schizophrenia, schizotypal, and schizoaffective disorders decreased at the beginning of the pandemic. Nevertheless, in the following months, the admissions returned to a trend similar to the prepandemic period. The systematization of online resources will be one of the main legacies to mental health care, including schizophrenia. We believe one of the main limitations of the policies adopted was the decision to not prioritize COVID-19 vaccination in patients with severe psychiatric disorders, despite preliminary evidence of a higher risk of complications in this group. The coronavirus pandemic is still ongoing and a longer time will be required to have a better perspective of its effects, but we expect this record of challenges and insights about the lessons learned during the pandemic can help healthcare professionals to face similar situations in the future.
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Affiliation(s)
- Ary Gadelha
- To whom correspondence should be addressed; Rua Major Maragliano, 241 - Vila Mariana, São Paulo. SP, CEP 04017-030, Brazil; e-mail:
| | - Raphael de O Cerqueira
- Schizophrenia Program, Department of Psychiatry, São Paulo School of Medicine, Federal University of São Paulo, São Paulo-SP, Brazil
- Department of Psychiatry and Psychological Medicine, Federal University of São Paulo, São Paulo-SP, Brazil
| | - Jair Mari
- Schizophrenia Program, Department of Psychiatry, São Paulo School of Medicine, Federal University of São Paulo, São Paulo-SP, Brazil
- Department of Psychiatry and Psychological Medicine, Federal University of São Paulo, São Paulo-SP, Brazil
| | - Carolina Ziebold
- Schizophrenia Program, Department of Psychiatry, São Paulo School of Medicine, Federal University of São Paulo, São Paulo-SP, Brazil
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Tognin S, Richter A, Kempton MJ, Modinos G, Antoniades M, Azis M, Allen P, Bossong MG, Perez J, Pantelis C, Nelson B, Amminger P, Riecher-Rössler A, Barrantes-Vidal N, Krebs MO, Glenthøj B, Ruhrmann S, Sachs G, Rutten BPF, de Haan L, van der Gaag M, Valmaggia LR, McGuire P, Antoniades M, Pisani S, Modinos G, de Haan L, van der Gaag M, Velthorst E, Kraan TC, van Dam DS, Burger N, Nelson B, McGorry P, Amminger GP, Pantelis C, Politis A, Goodall J, Riecher-Rössler A, Borgwardt S, Studerus E, Bressan R, Gadelha A, Brietzke E, Asevedo G, Asevedo E, Zugman A, Barrantes-Vidal N, Domínguez-Martínez T, Racciopi A, Kwapil TR, Monsonet M, Hinojosa L, Kazes M, Daban C, Bourgin J, Gay O, Mam-Lam-Fook C, Krebs MO, Nordholm D, Randers L, Krakauer K, Glenthøj L, Glenthøj B, Nordentoft M, Ruhrmann S, Gebhard D, Arnhold J, Klosterkötter J, Sachs G, Lasser I, Winklbaur B, Aschauer H, Delespaul PA, Rutten BP, van Os J, Valmaggia LR, McGuire P. The Relationship Between Grey Matter Volume and Clinical and Functional Outcomes in People at Clinical High Risk for Psychosis. Schizophr Bull Open 2022; 3:sgac040. [PMID: 35903803 PMCID: PMC9309497 DOI: 10.1093/schizbullopen/sgac040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Objective To examine the association between baseline alterations in grey matter volume (GMV) and clinical and functional outcomes in people at clinical high risk (CHR) for psychosis. Methods 265 CHR individuals and 92 healthy controls were recruited as part of a prospective multi-center study. After a baseline assessment using magnetic resonance imaging (MRI), participants were followed for at least two years to determine clinical and functional outcomes, including transition to psychosis (according to the Comprehensive Assessment of an At Risk Mental State, CAARMS), level of functioning (according to the Global Assessment of Functioning), and symptomatic remission (according to the CAARMS). GMV was measured in selected cortical and subcortical regions of interest (ROI) based on previous studies (ie orbitofrontal gyrus, cingulate gyrus, gyrus rectus, inferior temporal gyrus, parahippocampal gyrus, striatum, and hippocampus). Using voxel-based morphometry, we analysed the relationship between GMV and clinical and functional outcomes. Results Within the CHR sample, a poor functional outcome (GAF < 65) was associated with relatively lower GMV in the right striatum at baseline (P < .047 after Family Wise Error correction). There were no significant associations between baseline GMV and either subsequent remission or transition to psychosis. Conclusions In CHR individuals, lower striatal GMV was associated with a poor level of overall functioning at follow-up. This finding was not related to effects of antipsychotic or antidepressant medication. The failure to replicate previous associations between GMV and later psychosis onset, despite studying a relatively large sample, is consistent with the findings of recent large-scale multi-center studies.
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Affiliation(s)
- Stefania Tognin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Anja Richter
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Mathilde Antoniades
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Matilda Azis
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Matthijs G Bossong
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Jesus Perez
- CAMEO Early Intervention in Psychosis Services, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Christos Pantelis
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne & Melbourne Health, Carlton South, Victoria, Australia
| | | | | | | | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Fundació Sanitària Sant Pere Claver (Spain), Center for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
| | - Marie-Odile Krebs
- University of Paris, GHU-Paris, Sainte-Anne, C'JAAD, Hospitalo-Universitaire department SHU, Inserm U1266, Institut de Psychiatrie (CNRS 3557), Paris, France
| | - Birte Glenthøj
- Center for Neuropsychiatric Schizophrenia Research, CNSR, and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Services Capital Region of Denmark, Mental Health Center Glostrup, Glostrup, Denmark
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital University of Cologne, Cologne, Germany
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Lieuwe de Haan
- Early Psychosis Department, Amsterdam UMC, Amsterdam, The Netherlands
| | - Mark van der Gaag
- Department of Clinical Psychology and Amsterdam Public Mental Health Research Institute, Faculty of Behavioural and Movement Sciences, VU University, Amsterdam, The Netherlands
| | | | - Lucia R Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Lucia R Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London , UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London , UK
- National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) , UK
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Bado P, Schafer J, Simioni AR, Bressan RA, Gadelha A, Pan PM, Miguel EC, Rohde LA, Salum GA. Screen time and psychopathology: investigating directionality using cross-lagged panel models. Eur Child Adolesc Psychiatry 2022; 31:689-691. [PMID: 33175314 PMCID: PMC7656505 DOI: 10.1007/s00787-020-01675-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/24/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Patricia Bado
- Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal Do Rio Grande Do Sul (UFRGS), Rua Ramiro Barcelos, 2350/2202, Porto Alegre, Rio Grande do Sul, 90035-003, Brazil.
| | - Julia Schafer
- Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal Do Rio Grande Do Sul (UFRGS), Rua Ramiro Barcelos, 2350/2202, Porto Alegre, Rio Grande do Sul, 90035-003, Brazil
| | - Andre R Simioni
- Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal Do Rio Grande Do Sul (UFRGS), Rua Ramiro Barcelos, 2350/2202, Porto Alegre, Rio Grande do Sul, 90035-003, Brazil
| | - Rodrigo A Bressan
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
- Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Ary Gadelha
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
- Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Pedro M Pan
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
- Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Eurípedes C Miguel
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
- Universidade de São Paulo (USP), São Paulo, Brazil
| | - Luis A Rohde
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
- ADHD Outpatient Program and Developmental Psychiatry Program, Hospital de Clínicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Giovanni A Salum
- Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal Do Rio Grande Do Sul (UFRGS), Rua Ramiro Barcelos, 2350/2202, Porto Alegre, Rio Grande do Sul, 90035-003, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
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dos Reis MA, Gadelha A, Felício AC, Hoexter MQ, Batista IR, Braga-Neto P, Calzavara M, Cavagnolli DA, Higuchi C, Leite MFL, Nogueira SA, Wagner J, Castiglioni MLV, Shih MC, Bressan RA. Evaluation of dopamine transporter density in healthy Brazilians using Tc-99m TRODAT-1 SPECT. Medicine (Baltimore) 2021; 100:e27192. [PMID: 34596116 PMCID: PMC8483821 DOI: 10.1097/md.0000000000027192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/22/2021] [Indexed: 01/05/2023] Open
Abstract
The presynaptic dopamine transporter (DAT) modulates the uptake of dopamine by regulating its concentration in the central nervous system. We aimed to evaluate the DAT binding potential (DAT-BP) in a sample of healthy Brazilians through technetium-99 metastable TRODAT-1 single-photon emission computed tomography imaging.We selected 126 healthy individuals comprising 72 men and 54 women, aged 18 to 80 years. We conducted semi-quantitative evaluation in transaxial slices, following which we identified the regions of interest in the striatal region using the occipital lobe as a region of non-specific DAT-BP.We found a decrease in DAT-BP in healthy individuals aged over 30 years, culminating in a 42% mean reduction after 80 years. There was no difference in the decrease by age group between the right (linear regression test [R2] linear = 0.466) and left striatum (R2 linear = 0.510). Women presented a higher DAT-BP than men (women: R2 linear = 0.431; men: R2 linear = 0.457); nonetheless, their decrease by age group was equal to that in men.Our study sheds light on important DAT-BP findings in healthy Brazilian subjects. Our results will facilitate understanding of brain illnesses that involve the dopamine system, such as neuropsychiatric disorders.
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Affiliation(s)
- Marilia Alves dos Reis
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo (LiNC- EPM/UNIFESP), São Paulo, Brazil
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Department of Diagnostic Imaging, Universidade Federal de São Paulo (DDI/UNIFESP), São Paulo, Brazil
| | - Ary Gadelha
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo (LiNC- EPM/UNIFESP), São Paulo, Brazil
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Schizophrenia Program of the Department of Psychiatry, Universidade Federal de São Paulo (PROESQ – EPM/UNIFESP), São Paulo, Brazil
| | | | | | - Ilza Rosa Batista
- Department of Diagnostic Imaging, Universidade Federal de São Paulo (DDI/UNIFESP), São Paulo, Brazil
| | - Pedro Braga-Neto
- Neurology Division, Department of Clinical Medicine, Universidade Federal do Ceará, Ceará, Brazil
- Center of Health Sciences, Universidade Estadual do Ceará, Ceará, Brazil
| | - Mariana Calzavara
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Cinthia Higuchi
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo (LiNC- EPM/UNIFESP), São Paulo, Brazil
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Schizophrenia Program of the Department of Psychiatry, Universidade Federal de São Paulo (PROESQ – EPM/UNIFESP), São Paulo, Brazil
| | | | | | - Jairo Wagner
- Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | - Ming Chi Shih
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Rodrigo Affonseca Bressan
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo (LiNC- EPM/UNIFESP), São Paulo, Brazil
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Schizophrenia Program of the Department of Psychiatry, Universidade Federal de São Paulo (PROESQ – EPM/UNIFESP), São Paulo, Brazil
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Aceituno D, Mena C, Vera N, Gonzalez-Valderrama A, Gadelha A, Diniz E, Crossley N, Pennington M, Prina M. Implementation of early psychosis services in Latin America: A scoping review. Early Interv Psychiatry 2021; 15:1104-1114. [PMID: 33047889 DOI: 10.1111/eip.13060] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 09/26/2020] [Indexed: 12/01/2022]
Abstract
AIM The evidence of the effectiveness and cost-effectiveness of early intervention for psychosis (EIP) services has motivated their implementation worldwide. However, complex interventions of such EIP services require local adaptations to successfully match population needs and cultural differences. Latin America is a heterogenous region where EIP services are progressively being adopted. Our aim is to map such initiatives in the region with a focus on implementation outcomes. METHODS A scoping review following the Preferred Reporting Items for Systematic review and Meta-Analysis extension for Scoping Reviews guidelines was conducted. International and regional databases were searched for publications describing EIP programmes in the region. Besides mapping the services, we described implementation outcomes based on the Standards for Reporting Implementation Studies Checklist. RESULTS Ten articles describing seven EIP initiatives from the region were found. Four countries were represented: Argentina, Brazil, Chile and Mexico. The implementation outcomes reporting was heterogenous, although it was possible to ascertain EIP services are feasible and adequate for the region's context. Also, there is some evidence of effectiveness in terms of reducing hospitalizations and improving symptoms. Information about fidelity measures was scarce and there was no information about costs or cost-effectiveness. CONCLUSIONS Only a small proportion of Latin American countries have adopted EIP services. Although these programmes seem to be feasible and effective, data on other implementation outcomes, such as fidelity, cultural appropriateness, cost-effectiveness and affordability are not available. This might in part explain why this effective approach has not been yet scaled-up at nationwide levels.
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Affiliation(s)
- David Aceituno
- Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cristián Mena
- Early Intervention Program, J. Horwitz Psychiatric Institute, Santiago, Chile.,School of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Norha Vera
- Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alfonso Gonzalez-Valderrama
- Early Intervention Program, J. Horwitz Psychiatric Institute, Santiago, Chile.,School of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Ary Gadelha
- Programa de Esquizofrenia (PROESQ), Department of Psychiatry, School of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil.,Centro de Pesquisa e Inovação em Prevenção de Transtornos Mentais e uso de álcool e outras drogas (CEPIPREV), School of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Elton Diniz
- Programa de Esquizofrenia (PROESQ), Department of Psychiatry, School of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Nicolas Crossley
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mark Pennington
- Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Matthew Prina
- Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Dias CL, Fonseca L, Gadelha A, Noto C. Clozapine-induced hepatotoxicity: A life threatening situation. Schizophr Res 2021; 235:3-4. [PMID: 34274796 DOI: 10.1016/j.schres.2021.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 06/25/2021] [Accepted: 07/11/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Cíntia Lopes Dias
- Department of Psychiatry, UNIFESP/EPM, Rua Pedro de Toledo, 669, 3o andar, São Paulo, SP, Brazil
| | - Lais Fonseca
- Department of Psychiatry, UNIFESP/EPM, Rua Pedro de Toledo, 669, 3o andar, São Paulo, SP, Brazil
| | - Ary Gadelha
- Department of Psychiatry, UNIFESP/EPM, Rua Pedro de Toledo, 669, 3o andar, São Paulo, SP, Brazil
| | - Cristiano Noto
- Department of Psychiatry, UNIFESP/EPM, Rua Pedro de Toledo, 669, 3o andar, São Paulo, SP, Brazil.
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40
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Orsi JA, Malinowski FRL, Kagan S, Weingarten R, Villares CC, Bressan RA, de Oliveira WF, Andrade MCR, Gadelha A. Evaluation of Ongoing Participation of People with Schizophrenia in a Mutual Support Group as a Complementary Intervention to Outpatient Psychiatric Treatment. Psychiatr Q 2021; 92:1283-1296. [PMID: 33761085 DOI: 10.1007/s11126-021-09893-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/31/2021] [Indexed: 10/21/2022]
Abstract
This study aims to evaluate a group of people with schizophrenia undergoing outpatient treatment and who participate in a mutual support intervention, compared to another group of people with the same diagnosis, but attending only the usual outpatient treatment. This is a prospective study, with two measurements between six months. The mutual support group was initially composed of 16 people and the treatment as usual group was composed of 15 people. Clinical (medication adherence and functioning) and Recovery (hope, well-being, recovery and internalized stigma) outcomes were assessed. Nonparametric tests were used to verify differences in measurements between groups and between two moments. A higher level of internalized stigma and a decrease in the adherence to drug treatment in the treatment as usual group were verified. When comparing the pre-post difference between groups, there was a greater increase in adherence to drug treatment in the mutual support group. Our data point to more favorable results in the mutual support group, showing that ongoing participation in these groups is an important tool for the recovery process and for the treatment itself.
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Affiliation(s)
- José Alberto Orsi
- Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), Schizophrenia Program (Proesq), Department of Psychiatry, Universidade Federal de São Paulo, R. Maj. Maragliano, 241 - Vila Mariana, São Paulo, SP, CEP 04017-030, Brazil. .,Brazilian Schizophrenia Association (ABRE), São Paulo, SP, Brazil.
| | - Fernando Rocha Loures Malinowski
- Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), Schizophrenia Program (Proesq), Department of Psychiatry, Universidade Federal de São Paulo, R. Maj. Maragliano, 241 - Vila Mariana, São Paulo, SP, CEP 04017-030, Brazil
| | - Simão Kagan
- Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), Schizophrenia Program (Proesq), Department of Psychiatry, Universidade Federal de São Paulo, R. Maj. Maragliano, 241 - Vila Mariana, São Paulo, SP, CEP 04017-030, Brazil
| | - Richard Weingarten
- Formerly, Yale University School of Medicine, Yale University, New Haven, CT, USA
| | - Cecília Cruz Villares
- Brazilian Schizophrenia Association (ABRE), São Paulo, SP, Brazil.,NOOS Institute, São Paulo, SP, Brazil
| | - Rodrigo Affonseca Bressan
- Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), Schizophrenia Program (Proesq), Department of Psychiatry, Universidade Federal de São Paulo, R. Maj. Maragliano, 241 - Vila Mariana, São Paulo, SP, CEP 04017-030, Brazil
| | | | | | - Ary Gadelha
- Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), Schizophrenia Program (Proesq), Department of Psychiatry, Universidade Federal de São Paulo, R. Maj. Maragliano, 241 - Vila Mariana, São Paulo, SP, CEP 04017-030, Brazil
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41
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Noto MN, Maes M, Vargas Nunes SO, Ota VK, Cavalcante D, Oliveira G, Rossaneis AC, Verri WA, Cordeiro Q, Belangero SI, Gadelha A, Noto C, Bressan RA. BDNF in antipsychotic naive first episode psychosis: Effects of risperidone and the immune-inflammatory response system. J Psychiatr Res 2021; 141:206-213. [PMID: 34246975 DOI: 10.1016/j.jpsychires.2021.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 06/04/2021] [Accepted: 07/05/2021] [Indexed: 12/25/2022]
Abstract
Brain-derived neurotrophic factor (BDNF) and the immune-inflammatory response system (IRS) have been implicated in the pathophysiology of schizophrenia. However, no research examined the associations between BDNF and immune activation both before and after treatment in antipsychotic-naïve first episode psychosis (AN-FEP). This study aims to examine serum BDNF levels and their association with IRS and the compensatory immune-regulatory reflex system (CIRS) in AN-FEP before and after risperidone treatment. We included 31 AN-FEP and 22 healthy controls. AN-FEP showed reduced levels of BDNF as compared to controls, and BDNF levels normalized after treatment with risperidone. BDNF levels were inversely correlated with a greater IRS response. Higher levels of IRS/CIRS biomarkers were associated with lower levels of BDNF including M1 macrophage, T-helper (Th)-1, Th-2, and Th-17, and T-regulatory (Treg) cell responses. Our findings indicate that AN-FEP is characterized by decreased levels of BDNF, which are normalized after treatment with risperidone. BDNF levels were inversely associated with activated immune-inflammatory pathways. The findings support the hypothesis that, increased IRS is linked to neurotoxicity, and that a decrease in BDNF may be part of the IRS/CIRS responses in FEP and, thus, be involved in the development of psychosis.
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Affiliation(s)
- Mariane Nunes Noto
- GAPi (Early Psychosis Group), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Michael Maes
- Department of Psychiatry, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria; IMPACT, Deakin University, Geelong, Australia
| | | | - Vanessa Kiyomi Ota
- Genetics Division, Department of Morphology and Genetics, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Daniel Cavalcante
- GAPi (Early Psychosis Group), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Giovany Oliveira
- GAPi (Early Psychosis Group), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil; Genetics Division, Department of Morphology and Genetics, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Ana C Rossaneis
- Department of Pathology, Biological Sciences Center, State University of Londrina (UEL), Londrina, Brazil
| | - Waldiceu A Verri
- Department of Pathology, Biological Sciences Center, State University of Londrina (UEL), Londrina, Brazil
| | - Quirino Cordeiro
- Department of Psychiatry, Faculdade de Ciências Médica da Santa Casa de São Paulo (FCMSCSP), São Paulo, Brazil
| | - Sintia Iole Belangero
- Genetics Division, Department of Morphology and Genetics, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Ary Gadelha
- GAPi (Early Psychosis Group), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil; Schizophrenia Program (PROESQ), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Cristiano Noto
- GAPi (Early Psychosis Group), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil; Schizophrenia Program (PROESQ), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
| | - Rodrigo Affonseca Bressan
- GAPi (Early Psychosis Group), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil; Schizophrenia Program (PROESQ), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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42
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Affiliation(s)
- Carlos G Costardi
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Ary Gadelha
- Programa de Esquizofrenia (PROESQ), Departamento de Psiquiatria, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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43
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Sato JR, Biazoli CE, Zugman A, Pan PM, Bueno APA, Moura LM, Gadelha A, Picon FA, Amaro E, Salum GA, Miguel EC, Rohde LA, Bressan RA, Jackowski AP. Long-term stability of the cortical volumetric profile and the functional human connectome throughout childhood and adolescence. Eur J Neurosci 2021; 54:6187-6201. [PMID: 34460993 DOI: 10.1111/ejn.15435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 08/18/2021] [Accepted: 08/28/2021] [Indexed: 11/26/2022]
Abstract
There is compelling evidence showing that between-subject variability in several functional and structural brain features is sufficient for unique identification in adults. However, individuation of brain functional connectomes depends on the stabilization of neurodevelopmental processes during childhood and adolescence. Here, we aimed to (1) evaluate the intra-subject functional connectome stability over time for the whole brain and for large scale functional networks and (2) determine the long-term identification accuracy or 'fingerprinting' for the cortical volumetric profile and the functional connectome. For these purposes, we analysed a longitudinal cohort of 239 children and adolescents scanned in two sessions with an interval of approximately 3 years (age range 6-15 years at baseline and 9-18 years at follow-up). Corroborating previous results using short between-scan intervals in children and adolescents, we observed a moderate identification accuracy (38%) for the whole functional profile. In contrast, identification accuracy using cortical volumetric profile was 95%. Among the large-scale networks, the default-mode (26.8%), the frontoparietal (23.4%) and the dorsal-attention (27.6%) networks were the most discriminative. Our results provide further evidence for a protracted development of specific individual structural and functional connectivity profiles.
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Affiliation(s)
- João Ricardo Sato
- Center of Mathematics, Computing, and Cognition, Universidade Federal do ABC, Santo André, Brazil.,Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo, Brazil
| | - Claudinei Eduardo Biazoli
- Center of Mathematics, Computing, and Cognition, Universidade Federal do ABC, Santo André, Brazil.,Department of Biological and Experimental Psychology, Queen Mary University of London, London, UK
| | - André Zugman
- Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo, Brazil
| | - Pedro Mario Pan
- Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo, Brazil
| | - Ana Paula Arantes Bueno
- Center of Mathematics, Computing, and Cognition, Universidade Federal do ABC, Santo André, Brazil
| | - Luciana Monteiro Moura
- Center of Mathematics, Computing, and Cognition, Universidade Federal do ABC, Santo André, Brazil.,Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo, Brazil
| | - Ary Gadelha
- Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo, Brazil
| | - Felipe Almeida Picon
- National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo, Brazil.,ADHD Outpatient Program & Developmental Psychiatry Program, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Edson Amaro
- National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo, Brazil.,Department of Radiology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Giovanni Abrahão Salum
- National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo, Brazil.,ADHD Outpatient Program & Developmental Psychiatry Program, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Euripedes Constantino Miguel
- National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo, Brazil.,Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Luis Augusto Rohde
- National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo, Brazil.,ADHD Outpatient Program & Developmental Psychiatry Program, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Rodrigo Affonseca Bressan
- Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo, Brazil
| | - Andrea Parolin Jackowski
- Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), São Paulo, Brazil
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44
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Aguiar AP, Vistorte AOR, Akiba HT, Oliveira P, Ruiz DPP, Gadelha A, Bressan RA, Pan PM. Translation and cross-cultural adaptation to Brazilian Portuguese of two brief screening tools for at-risk psychosis youth: the Prodromal Questionnaire (PQ-16) and the PRIME-Screen. Trends Psychiatry Psychother 2021; 45:e20210276. [PMID: 34551241 PMCID: PMC10164406 DOI: 10.47626/2237-6089-2021-0276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 07/28/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Prodromal characteristics of psychosis have been described for more than a century. Over the last three decades, a variety of studies have proposed methods to prospectively identify individuals (and youth in particular) who are at high risk of developing a psychotic disorder. These studies have validated various screening instruments and made them available in several languages. Here, we describe the translation into Brazilian Portuguese and cross-cultural adaptation of two such screening tools - the Prodromal Questionnaire-16 (PQ-16) and the Prevention through Risk Identification, Management, and Education (PRIME)-Screen. METHOD Two bilingual native speakers of Brazilian Portuguese translated the questionnaires from English. A native English speaker then performed back-translations into English. These back-translated versions were submitted to the original authors. They provided feedback and later approved the final versions. RESULTS After translation and cross-cultural adaptation, no items needed to be changed in the adapted PQ-16 and four items were revised in the PRIME-Screen. After the peer-review process, we included two suggestions in the PQ-16 to facilitate use of the tool in our cultural and social contexts. The PRIME-Screen did not need further changes. CONCLUSION These new instruments can help screen Brazilian Portuguese-speaking patients who are at risk of psychosis in primary care.
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Affiliation(s)
- Ana Paula Aguiar
- Programa de Reconhecimento e Intervenção em Estados Mentais de RiscoDepartamento de PsiquiatriaUniversidade Federal de São PauloSão PauloSPBrazil Programa de Reconhecimento e Intervenção em Estados Mentais de Risco (PRISMA), Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
- Instituto Ame Sua MenteSão PauloSPBrazil Instituto Ame Sua Mente, São Paulo, SP, Brazil.
| | - Angel Olider Rojas Vistorte
- Programa de Reconhecimento e Intervenção em Estados Mentais de RiscoDepartamento de PsiquiatriaUniversidade Federal de São PauloSão PauloSPBrazil Programa de Reconhecimento e Intervenção em Estados Mentais de Risco (PRISMA), Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
- Instituto Ame Sua MenteSão PauloSPBrazil Instituto Ame Sua Mente, São Paulo, SP, Brazil.
| | - Henrique Teruo Akiba
- Programa de Reconhecimento e Intervenção em Estados Mentais de RiscoDepartamento de PsiquiatriaUniversidade Federal de São PauloSão PauloSPBrazil Programa de Reconhecimento e Intervenção em Estados Mentais de Risco (PRISMA), Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
- Instituto Ame Sua MenteSão PauloSPBrazil Instituto Ame Sua Mente, São Paulo, SP, Brazil.
| | - Paula Oliveira
- Programa de Reconhecimento e Intervenção em Estados Mentais de RiscoDepartamento de PsiquiatriaUniversidade Federal de São PauloSão PauloSPBrazil Programa de Reconhecimento e Intervenção em Estados Mentais de Risco (PRISMA), Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
- Instituto Ame Sua MenteSão PauloSPBrazil Instituto Ame Sua Mente, São Paulo, SP, Brazil.
| | - Deise Palermo Puertas Ruiz
- Programa de Reconhecimento e Intervenção em Estados Mentais de RiscoDepartamento de PsiquiatriaUniversidade Federal de São PauloSão PauloSPBrazil Programa de Reconhecimento e Intervenção em Estados Mentais de Risco (PRISMA), Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
- Instituto Ame Sua MenteSão PauloSPBrazil Instituto Ame Sua Mente, São Paulo, SP, Brazil.
| | - Ary Gadelha
- Instituto Ame Sua MenteSão PauloSPBrazil Instituto Ame Sua Mente, São Paulo, SP, Brazil.
- Programa de EsquizofreniaUNIFESPSão PauloSPBrazil Programa de Esquizofrenia (PROESQ), UNIFESP, São Paulo, SP, Brazil.
| | - Rodrigo Affonseca Bressan
- Programa de Reconhecimento e Intervenção em Estados Mentais de RiscoDepartamento de PsiquiatriaUniversidade Federal de São PauloSão PauloSPBrazil Programa de Reconhecimento e Intervenção em Estados Mentais de Risco (PRISMA), Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
- Instituto Ame Sua MenteSão PauloSPBrazil Instituto Ame Sua Mente, São Paulo, SP, Brazil.
| | - Pedro Mario Pan
- Programa de Reconhecimento e Intervenção em Estados Mentais de RiscoDepartamento de PsiquiatriaUniversidade Federal de São PauloSão PauloSPBrazil Programa de Reconhecimento e Intervenção em Estados Mentais de Risco (PRISMA), Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
- Instituto Ame Sua MenteSão PauloSPBrazil Instituto Ame Sua Mente, São Paulo, SP, Brazil.
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Costardi CG, Cavalcante DA, Macêdo MA, Cerqueira RDO, Rios MC, Noto C, Gadelha A. COVID-19 pandemic and distinct patterns of psychotic outbreaks. Trends Psychiatry Psychother 2021; 43:335-337. [PMID: 34043904 PMCID: PMC8835383 DOI: 10.47626/2237-6089-2020-0188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/27/2021] [Indexed: 12/02/2022]
Affiliation(s)
- Carlos Gustavo Costardi
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Escola Paulista de Medicina - Universidade Federal de São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
| | - Daniel A Cavalcante
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Escola Paulista de Medicina - Universidade Federal de São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil. Grupo de Atenção às Psicoses Iniciais (GAPi), Departamento de Psiquiatria, EPM-UNIFESP, São Paulo, SP, Brazil
| | - Marcos Antônio Macêdo
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Escola Paulista de Medicina - Universidade Federal de São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
| | - Raphael de O Cerqueira
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Escola Paulista de Medicina - Universidade Federal de São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
| | - Maria Carolina Rios
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Escola Paulista de Medicina - Universidade Federal de São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
| | - Cristiano Noto
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Escola Paulista de Medicina - Universidade Federal de São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil. Grupo de Atenção às Psicoses Iniciais (GAPi), Departamento de Psiquiatria, EPM-UNIFESP, São Paulo, SP, Brazil. Programa de Esquizofrenia (PROESQ), Departamento de Psiquiatria, EPM-UNIFESP, São Paulo, SP, Brazil. Centro de Pesquisa e Inovação em Prevenção de Transtornos Mentais e Uso de Álcool e Outras Drogas (CEPIPREV), EPM-UNIFESP, São Paulo, SP, Brazil
| | - Ary Gadelha
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Escola Paulista de Medicina - Universidade Federal de São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil. Grupo de Atenção às Psicoses Iniciais (GAPi), Departamento de Psiquiatria, EPM-UNIFESP, São Paulo, SP, Brazil. Programa de Esquizofrenia (PROESQ), Departamento de Psiquiatria, EPM-UNIFESP, São Paulo, SP, Brazil. Centro de Pesquisa e Inovação em Prevenção de Transtornos Mentais e Uso de Álcool e Outras Drogas (CEPIPREV), EPM-UNIFESP, São Paulo, SP, Brazil
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Mari JJ, Gadelha A, Kieling C, Ferri CP, Kapczinski F, Nardi AE, Almeida-Filho N, Sanchez ZM, Salum GA. Translating science into policy: mental health challenges during the COVID-19 pandemic. ACTA ACUST UNITED AC 2021; 43:638-649. [PMID: 33710250 PMCID: PMC8639016 DOI: 10.1590/1516-4446-2020-1577] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 12/02/2020] [Indexed: 12/20/2022]
Abstract
Several stressors associated with the coronavirus disease 2019 (COVID-19) are expected to affect the mental health of global populations: the effects of physical distancing, quarantine, and social isolation; the emotional suffering of health and other frontline workers; neuropsychiatric sequelae in those affected by the virus; the impact to families of lives lost to the disease; differential effects for those with severe mental disorders; and the consequences of social and economic deterioration. In this context, we sought: to form a panel of Brazilian experts on child and adolescent health, neurodevelopment, health services, and adult and elderly mental health; and to compile evidence-based interventions to support suggested policy changes in Brazil to mitigate the expected increase in mental health disorders during the pandemic and its mental health consequences. The following actions are recommended: 1) invest in prevention programs for the safe return of students to schools; 2) adopt evidence-based psychosocial interventions to maintain an adequate environment for child and adolescent development; 3) target socially vulnerable populations and those experiencing discrimination; 4) train primary care teams to solve common mental health problems, provide needs-based assessments, and manage long-term, at-home care for older patients; 5) invest in technological advancements (e.g., telemedicine, e-Health, and web-based algorithms) to promote coordinated care; 6) increase access to and literacy in the use of computers and mobile phones, especially among older adults; 7) expand protocols for remote, brief psychotherapy interventions and psychoeducation to manage common mental health problems.
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Affiliation(s)
- Jair J Mari
- Departamento de Psiquiatria e Psicologia Médica, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Ary Gadelha
- Departamento de Psiquiatria e Psicologia Médica, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Christian Kieling
- Serviço de Psiquiatria da Infância e Adolescência, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Departamento de Psiquiatria e Medicina Legal, UFRGS, Porto Alegre, RS, Brazil
| | - Cleusa P Ferri
- Departamento de Psiquiatria e Psicologia Médica, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Flavio Kapczinski
- Departamento de Psiquiatria, UFRGS, Porto Alegre, RS, Brazil.,McMaster University, Hamilton, Canada
| | - Antonio E Nardi
- Instituto de Psiquiatria, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,Academia Nacional de Medicina, Rio de Janeiro, RJ, Brazil.,Academia Brasileira de Ciências, Rio de Janeiro, RJ, Brazil
| | - Naomar Almeida-Filho
- Instituto de Estudos Avançados, Universidade de São Paulo, São Paulo, SP, Brazil.,Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Zila M Sanchez
- Departamento de Medicina Preventiva, Escola Paulista de Medicina, UNIFESP, São Paulo, SP, Brazil
| | - Giovanni A Salum
- Seção de Afeto Negativo e Processos Sociais, Departamento de Psiquiatria e Medicina Legal, HCPA, UFRGS, Porto Alegre, RS, Brazil
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47
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Crossley NA, Zugman A, Reyes-Madrigal F, Czepielewski LS, Castro MN, Diaz-Zuluaga AM, Pineda-Zapata JA, Reckziegel R, Gadelha A, Jackowski A, Noto C, Alliende LM, Iruretagoyena B, Ossandon T, Ramirez-Mahaluf JP, Castañeda CP, Gonzalez-Valderrama A, Nachar R, León-Ortiz P, Undurraga J, López-Jaramillo C, Guinjoan SM, Gama CS, de la Fuente-Sandoval C, Bressan RA. Structural brain abnormalities in schizophrenia in adverse environments: examining the effect of poverty and violence in six Latin American cities. Br J Psychiatry 2021; 218:112-118. [PMID: 32807243 DOI: 10.1192/bjp.2020.143] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Social and environmental factors such as poverty or violence modulate the risk and course of schizophrenia. However, how they affect the brain in patients with psychosis remains unclear. AIMS We studied how environmental factors are related to brain structure in patients with schizophrenia and controls in Latin America, where these factors are large and unequally distributed. METHOD This is a multicentre study of magnetic resonance imaging in patients with schizophrenia and controls from six Latin American cities. Total and voxel-level grey matter volumes, and their relationship with neighbourhood characteristics such as average income and homicide rates, were analysed with a general linear model. RESULTS A total of 334 patients with schizophrenia and 262 controls were included. Income was differentially related to total grey matter volume in both groups (P = 0.006). Controls showed a positive correlation between total grey matter volume and income (R = 0.14, P = 0.02). Surprisingly, this relationship was not present in patients with schizophrenia (R = -0.076, P = 0.17). Voxel-level analysis confirmed that this interaction was widespread across the cortex. After adjusting for global brain changes, income was positively related to prefrontal cortex volumes only in controls. Conversely, the hippocampus in patients with schizophrenia, but not in controls, was relatively larger in affluent environments. There was no significant correlation between environmental violence and brain structure. CONCLUSIONS Our results highlight the interplay between environment, particularly poverty, and individual characteristics in psychosis. This is particularly important for harsh environments such as low- and middle-income countries, where potentially less brain vulnerability (less grey matter loss) is sufficient to become unwell in adverse (poor) environments.
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Affiliation(s)
- Nicolas A Crossley
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile; Biomedical Imaging Center, Pontificia Universidad Católica de Chile, Chile; and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Andre Zugman
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, Brazil
| | | | - Leticia S Czepielewski
- Department of the Psychology of Development and Personality, Institute of Psychology, Universidade Federal do Rio Grande do Sul, Brazil
| | - Mariana N Castro
- Universidad de Buenos Aires and Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Research Group on Neurosciences as applied to Abnormal Behaviour (INAAC Group), Instituto de Neurociencias Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia (FLENI)-CONICET, Argentina
| | - Ana M Diaz-Zuluaga
- Research Group in Psychiatry, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Colombia
| | | | - Ramiro Reckziegel
- Laboratory of Molecular Psychiatry, National Science and Technology Institute for Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil
| | - Ary Gadelha
- LiNC, Department of Psychiatry, Universidade Federal de São Paulo, Brazil
| | - Andrea Jackowski
- LiNC, Department of Psychiatry, Universidade Federal de São Paulo, Brazil
| | - Cristiano Noto
- LiNC, Department of Psychiatry, Universidade Federal de São Paulo, Brazil
| | - Luz M Alliende
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Chile
| | - Barbara Iruretagoyena
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Chile
| | - Tomas Ossandon
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile; and Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile, Chile
| | - Juan P Ramirez-Mahaluf
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Chile
| | - Carmen P Castañeda
- Early Intervention Program, Instituto Psiquiátrico Dr. José Horwitz Barak, Chile
| | - Alfonso Gonzalez-Valderrama
- Early Intervention Program, Instituto Psiquiátrico Dr. José Horwitz Barak; and School of Medicine, Universidad Finis Terrae, Chile
| | - Ruben Nachar
- Early Intervention Program, Instituto Psiquiátrico Dr. José Horwitz Barak, Chile
| | - Pablo León-Ortiz
- Medical Education, Instituto Nacional de Neurología y Neurocirugía; and Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico
| | - Juan Undurraga
- Early Intervention Program, Instituto Psiquiátrico Dr. José Horwitz Barak; and Department of Neurology and Psychiatry, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Chile
| | - Carlos López-Jaramillo
- Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia; and Mood Disorders Program, Hospital Universitario San Vicente Fundación, Colombia
| | - Salvador M Guinjoan
- Research Group on Neurosciences as applied to Abnormal Behaviour (INAAC Group), FLENI, Argentina; Department of Psychiatry and Mental Health, School of Medicine, Universidad de Buenos Aires; and National Scientific and Technical Research Council, Argentina
| | - Clarissa S Gama
- Laboratory of Molecular Psychiatry, National Science and Technology Institute for Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil
| | - Camilo de la Fuente-Sandoval
- Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía; and Department of Neuropsychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico
| | - Rodrigo A Bressan
- LiNC, Department of Psychiatry, Universidade Federal de São Paulo, Brazil
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Haguiara B, Koga G, Diniz E, Fonseca L, Higuchi CH, Kagan S, Lacerda A, Correll CU, Gadelha A. What is the Best Latent Structure of Negative Symptoms in Schizophrenia? A Systematic Review. Schizophrenia Bulletin Open 2021; 2:sgab013. [PMID: 34901862 PMCID: PMC8650068 DOI: 10.1093/schizbullopen/sgab013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Determining the best latent structure of negative symptoms in schizophrenia could benefit assessment tools, neurobiological research, and targeted interventions. However, no review systematically evaluated studies that assessed and validated latent models of negative symptoms. Objective To identify and evaluate existing latent structure models in the literature of negative symptoms and to determine the best model. Method Systematic search of MEDLINE, EMBASE, and Scopus on July 19, 2020, for confirmatory factor analysis models of negative symptoms in patients with schizophrenia. The available evidence was assessed through 2 sets of criteria: (1) study design quality—based on negative symptoms assessment and modeling strategy and (2) psychometric quality and model fit—based on fit indices and factor definition quality. Results In total, 22 studies (n = 17 086) from 9 countries were included. Studies differed greatly regarding symptom scales, setting, and sample size (range = 86–6889). Dimensional models included 2–6 factors (median = 4). Twelve studies evaluated competing models and adopted appropriate instruments to assess the latent structure of negative symptoms. The 5-factor and hierarchical models outperformed unitary, 2-factor, and 3-factor models on all direct comparisons, and most of the analyses derived from the Brief Negative Symptom Scale. Considering the quality criteria proposed, 5-factor and hierarchical models achieved excellent fit in just one study. Conclusions Our review points out that the 5-factor and hierarchical models represent the best latent structure of negative symptoms, but the immaturity of the relevant current literature may affect the robustness of this conclusion. Future studies should address current limitations regarding psychometric properties and also address biological and clinical validity to refine available models.
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Affiliation(s)
- Bernardo Haguiara
- Laboratory of Integrative Neurosciences, Department of Psychiatry, Escola Paulista de Medicina/Universidade Federal de São Paulo, SP, Brazil
| | - Gabriela Koga
- Laboratory of Integrative Neurosciences, Department of Psychiatry, Escola Paulista de Medicina/Universidade Federal de São Paulo, SP, Brazil
| | - Elton Diniz
- Laboratory of Integrative Neurosciences, Department of Psychiatry, Escola Paulista de Medicina/Universidade Federal de São Paulo, SP, Brazil
- Schizophrenia Program, Department of Psychiatry, Escola Paulista de Medicina/Universidade Federal de São Paulo, SP, Brazil
| | - Lais Fonseca
- Laboratory of Integrative Neurosciences, Department of Psychiatry, Escola Paulista de Medicina/Universidade Federal de São Paulo, SP, Brazil
- Schizophrenia Program, Department of Psychiatry, Escola Paulista de Medicina/Universidade Federal de São Paulo, SP, Brazil
| | - Cinthia H Higuchi
- Laboratory of Integrative Neurosciences, Department of Psychiatry, Escola Paulista de Medicina/Universidade Federal de São Paulo, SP, Brazil
| | - Simão Kagan
- Laboratory of Integrative Neurosciences, Department of Psychiatry, Escola Paulista de Medicina/Universidade Federal de São Paulo, SP, Brazil
| | - Acioly Lacerda
- Laboratory of Integrative Neurosciences, Department of Psychiatry, Escola Paulista de Medicina/Universidade Federal de São Paulo, SP, Brazil
- Schizophrenia Program, Department of Psychiatry, Escola Paulista de Medicina/Universidade Federal de São Paulo, SP, Brazil
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Ary Gadelha
- Laboratory of Integrative Neurosciences, Department of Psychiatry, Escola Paulista de Medicina/Universidade Federal de São Paulo, SP, Brazil
- Schizophrenia Program, Department of Psychiatry, Escola Paulista de Medicina/Universidade Federal de São Paulo, SP, Brazil
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49
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Cavalcante DA, Coutinho LS, Ortiz BB, Noto MN, Cordeiro Q, Ota VK, Belangeiro SI, Bressan RA, Gadelha A, Noto C. Impact of duration of untreated psychosis in short-term response to treatment and outcome in antipsychotic naïve first-episode psychosis. Early Interv Psychiatry 2020; 14:677-683. [PMID: 31637865 DOI: 10.1111/eip.12889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 07/16/2019] [Accepted: 09/24/2019] [Indexed: 12/31/2022]
Abstract
AIM Duration of untreated psychosis (DUP) is one of the few potentially modifiable outcome predictors in psychosis. Previous studies have associated a longer DUP with a poor prognosis, but few of them were performed in countries with low and middle level of income. This study aimed to investigate the DUP in a Brazilian sample of antipsychotic-naïve first-episode psychosis (AN-FEP) patients and its association with clinical characteristics and treatment outcomes in a short-term follow-up. METHODS One hundred forty-five AN-FEP patients between 16 and 40 years were enrolled and were reassessed 10 weeks after risperidone treatment. We investigated the association between DUP and symptom severity, functionality and response to treatment, using the Positive and Negative Syndrome Scale (PANSS), the Clinical Global Impression-Severity Scale (CGI) and the Global Assessment of Functionality (GAF) scale. DUP was defined as the period between the onset of the first psychotic symptoms and the first effective antipsychotic treatment. For the analysis, we performed multivariate linear regressions. RESULTS The DUP's median was 61 days. At baseline, we did not find any significant association between DUP and clinical characteristics. After treatment, the longer DUP predicted worse positive and negative symptom dimensions, worse total PANSS, GAF and CGI scores and poorer response to treatment. CONCLUSION Our results showed that DUP is associated with worse outcomes after short treatment, but it does not modify the baseline clinical profile of the AN-FEP patients. Such results reinforce the need to develop early intervention strategies, reducing DUP.
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Affiliation(s)
- Daniel A Cavalcante
- Department of Psychiatry, Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,GAPi (Early Psychosis Group), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Luccas S Coutinho
- Department of Psychiatry, Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Bruno B Ortiz
- Department of Psychiatry, Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Schizophrenia Program (PROESQ), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Mariane N Noto
- Department of Psychiatry, Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,GAPi (Early Psychosis Group), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Quirino Cordeiro
- Department of Psychiatry, Faculdade de Ciências Médica da Santa Casa de São Paulo (FCMSCSP), São Paulo, Brazil
| | - Vanessa K Ota
- Department of Psychiatry, Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Genetics Division, Department of Morphology and Genetics, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Sintia I Belangeiro
- Department of Psychiatry, Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Genetics Division, Department of Morphology and Genetics, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Rodrigo A Bressan
- Department of Psychiatry, Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Schizophrenia Program (PROESQ), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Ary Gadelha
- Department of Psychiatry, Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,GAPi (Early Psychosis Group), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Schizophrenia Program (PROESQ), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Cristiano Noto
- Department of Psychiatry, Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,GAPi (Early Psychosis Group), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Schizophrenia Program (PROESQ), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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50
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Fonseca L, Sena BF, Crossley N, Lopez-Jaramillo C, Koenen K, Freimer NB, Bressan RA, Belangero SI, Santoro ML, Gadelha A. Diversity matters: opportunities in the study of the genetics of psychotic disorders in low- and middle-income countries in Latin America. ACTA ACUST UNITED AC 2020; 43:631-637. [PMID: 33237255 PMCID: PMC8639010 DOI: 10.1590/1516-4446-2020-1240] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/22/2020] [Indexed: 01/15/2023]
Abstract
Lack of diversity regarding genetic and environmental backgrounds weakens the generalization and clinical applicability of research findings on psychotic disorders. Notably, Latin Americans have been generally neglected in genetic studies, comprising less than 2% of genome-wide association study samples. But Latin American populations represent a unique opportunity for research, given the exceptionally high ethnic admixture of this group. Increasing genetic diversity is essential to improve the fine mapping of known regions associated with psychotic disorders, discover novel genetic associations, and replicate studies. Additionally, Latin America is characterized by massive social, political, and economic inequalities, all known risk factors for mental health issues, including psychotic disorders. This article aims to 1) discuss the challenges and advantages of studying Latin America’s particular genetic makeup and environmental context; 2) review previous studies conducted in the region; and 3) describe three Latin American research initiatives in progress: the Neuropsychiatric Genetics of Psychosis in Mexican Populations (NeuroMEX), the Paisa, and the Latin American Network for the Study of Early Psychosis (ANDES) studies.
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Affiliation(s)
- Lais Fonseca
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.,Programa de Esquizofrenia (PROESQ), Departamento de Psiquiatria, UNIFESP, São Paulo, SP, Brazil
| | - Brena F Sena
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Stanley Center for Psychiatric Research, Broad Institute, Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, USA
| | - Nicolas Crossley
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Carlos Lopez-Jaramillo
- Research Group in Psychiatry, Department of Psychiatry, School of Medicine, Universidad de Antioquia, Medellin, Colombia.,Mood Disorders Program, Hospital San Vicente Fundación, Medellin, Colombia
| | - Karestan Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Stanley Center for Psychiatric Research, Broad Institute, Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, USA
| | - Nelson B Freimer
- Department of Psychiatry and Biobehavioral Sciences, University of California (UCLA), Los Angeles, CA, USA.,Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA.,Department of Human Genetics, UCLA, Los Angeles, CA, USA
| | - Rodrigo A Bressan
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.,Programa de Esquizofrenia (PROESQ), Departamento de Psiquiatria, UNIFESP, São Paulo, SP, Brazil
| | - Sintia I Belangero
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.,Disciplina de Genética, Departamento de Morfologia e Genética, UNIFESP, São Paulo, SP, Brazil
| | - Marcos L Santoro
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.,Disciplina de Genética, Departamento de Morfologia e Genética, UNIFESP, São Paulo, SP, Brazil
| | - Ary Gadelha
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.,Programa de Esquizofrenia (PROESQ), Departamento de Psiquiatria, UNIFESP, São Paulo, SP, Brazil
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